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. 2003 Sep;62(9):866–869. doi: 10.1136/ard.62.9.866

Reactive arthritis after an outbreak of Yersinia pseudotuberculosis serotype O:3 infection

T Hannu 1, L Mattila 1, J Nuorti 1, P Ruutu 1, J Mikkola 1, A Siitonen 1, M Leirisalo-Repo 1
PMCID: PMC1754663  PMID: 12922960

Abstract

Objective: To determine the occurrence and clinical characteristics of reactive arthritis (ReA) after an outbreak of Yersinia pseudotuberculosis serotype O:3 infection.

Methods: From 15 October to 6 November 1998, a widespread outbreak of Y pseudotuberculosis serotype O:3 occurred in Finland. A questionnaire on musculoskeletal symptoms was mailed to 38 patients with infection confirmed by culture. All patients who reported joint symptoms were interviewed by phone and their medical records of outpatient visits or hospital admission because of recent joint symptoms were reviewed.

Results: Thirty three of 38 (87%) patients returned the questionnaire. Reactive musculoskeletal symptoms were reported by 5/33 (15%): four patients (12%) fulfilled the criteria for ReA and one additional patient had reactive enthesopathy. The patients with ReA were adults (age range 40–47 years), whereas the patient with reactive enthesopathy was a 14 year old boy. In all patients with ReA, the arthritis was polyarticular. In addition to peripheral arthritis, other musculoskeletal symptoms included sacroiliitis (one patient), pain in Achilles tendon (one patient), and heel pain (two patients). HLA-B27 was positive in all the three patients tested. In three of four patients with ReA, the duration of acute arthritis was over six months.

Conclusion: Y pseudotuberculosis serotype O:3 infection is frequently associated with ReA and the clinical picture is severe.

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Selected References

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  1. Ahvonen P. Human yersiniosis in Finland. II. Clinical features. Ann Clin Res. 1972 Feb;4(1):39–48. [PubMed] [Google Scholar]
  2. Ahvonen P., Sievers K., Aho K. Arthritis associated with Yersinia enterocolitica infection. Acta Rheumatol Scand. 1969;15(3):232–253. doi: 10.3109/rhe1.1969.15.issue-1-4.32. [DOI] [PubMed] [Google Scholar]
  3. Bignardi G. E. Yersinia pseudotuberculosis and arthritis. Ann Rheum Dis. 1989 Jun;48(6):518–519. doi: 10.1136/ard.48.6.518. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cave M. H., MacAleenan F. A., Hunter J., Bell A. L., Curran R. Reactive arthritis following Yersinia pseudotuberculosis infection. Ulster Med J. 1990 Apr;59(1):87–89. [PMC free article] [PubMed] [Google Scholar]
  5. Chalmers A., Kaprove R. E., Reynolds W. J., Urowitz M. B. Postdiarrheal arthropathy of Yersinia pseudotuberculosis. Can Med Assoc J. 1978 Mar 4;118(5):515–516. [PMC free article] [PubMed] [Google Scholar]
  6. Fordham J. N., Maitra S. Post-yersinial arthritis in Cleveland, England. Ann Rheum Dis. 1989 Feb;48(2):139–142. doi: 10.1136/ard.48.2.139. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hannu T., Mattila L., Rautelin H., Pelkonen P., Lahdenne P., Siitonen A., Leirisalo-Repo M. Campylobacter-triggered reactive arthritis: a population-based study. Rheumatology (Oxford) 2002 Mar;41(3):312–318. doi: 10.1093/rheumatology/41.3.312. [DOI] [PubMed] [Google Scholar]
  8. Hällström K., Sairanen E., Ohela K. A pilot clinical study on yersinioses in South-Eastern Finland. Acta Med Scand. 1972 Jun;191(6):485–491. [PubMed] [Google Scholar]
  9. Iveson J. M., Nanda B. S., Hancock J. A., Pownall P. J., Wright V. Reiter's disease in three boys. Ann Rheum Dis. 1975 Aug;34(4):364–368. doi: 10.1136/ard.34.4.364. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kalliomäki J. L., Leino R. Follow-up studies of joint complications in yersiniosis. Acta Med Scand. 1979;205(6):521–525. doi: 10.1111/j.0954-6820.1979.tb06095.x. [DOI] [PubMed] [Google Scholar]
  11. Leino R., Kalliomäki J. L. Yersiniosis as an internal disease. Ann Intern Med. 1974 Oct;81(4):458–461. doi: 10.7326/0003-4819-81-4-458. [DOI] [PubMed] [Google Scholar]
  12. Leino R., Mäkelä A. L., Tiilikainen A., Toivanen A. Yersinia arthritis in children. Scand J Rheumatol. 1980;9(4):245–249. doi: 10.3109/03009748009112357. [DOI] [PubMed] [Google Scholar]
  13. Lindley R. I., Pattman R. S., Snow M. H. Yersinia pseudotuberculosis infection as a cause of reactive arthritis as seen in a genitourinary clinic: case report. Genitourin Med. 1989 Aug;65(4):255–256. doi: 10.1136/sti.65.4.255. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Lionarons R. J., van Zoeren M., Verhagen J. N., Lammers H. A. A case of reactive arthritis following Yersinia pseudotuberculosis enteritis. Neth J Med. 1987 Jun;30(5-6):278–280. [PubMed] [Google Scholar]
  15. Lockie G. N., Hunder G. G. Reiter's syndrome in children. A case report and review. Arthritis Rheum. 1971 Nov-Dec;14(6):767–772. doi: 10.1002/art.1780140614. [DOI] [PubMed] [Google Scholar]
  16. Mattila L., Leirisalo-Repo M., Koskimies S., Granfors K., Siitonen A. Reactive arthritis following an outbreak of Salmonella infection in Finland. Br J Rheumatol. 1994 Dec;33(12):1136–1141. doi: 10.1093/rheumatology/33.12.1136. [DOI] [PubMed] [Google Scholar]
  17. Mattila L., Leirisalo-Repo M., Pelkonen P., Koskimies S., Granfors K., Siitonen A. Reactive arthritis following an outbreak of Salmonella Bovismorbificans infection. J Infect. 1998 May;36(3):289–295. doi: 10.1016/s0163-4453(98)94243-8. [DOI] [PubMed] [Google Scholar]
  18. Mottier D., Pennec Y., Brousse A., Youinou P., Jouquan J., Bergeret G. Manifestations rhumatismales avec preésence d'anticorps anti-Yersinia pseudotuberculosis. A propos de quatre observations. Sem Hop. 1982 Sep 30;58(35):1989–1992. [PubMed] [Google Scholar]
  19. Pennec Y., Mottier D., Youinou P., Le Menn G. Reiter's disease and Yersinia pseudotuberculosis infection. J Rheumatol. 1981 Sep-Oct;8(5):868–869. [PubMed] [Google Scholar]
  20. Rahman M. Polyarthritis from Yersinia pseudotuberculosis: a British case of 'Far-Eastern scarlatiniform fever'? J Infect. 1983 May;6(3):279–280. doi: 10.1016/s0163-4453(83)93837-9. [DOI] [PubMed] [Google Scholar]
  21. Rudwaleit M., Richter S., Braun J., Sieper J. Low incidence of reactive arthritis in children following a salmonella outbreak. Ann Rheum Dis. 2001 Nov;60(11):1055–1057. doi: 10.1136/ard.60.11.1055. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Tertti R., Granfors K., Lehtonen O. P., Mertsola J., Mäkelä A. L., Välimäki I., Hänninen P., Toivanen A. An outbreak of Yersinia pseudotuberculosis infection. J Infect Dis. 1984 Feb;149(2):245–250. doi: 10.1093/infdis/149.2.245. [DOI] [PubMed] [Google Scholar]
  23. Tertti R., Vuento R., Mikkola P., Granfors K., Mäkelä A. L., Toivanen A. Clinical manifestations of Yersinia pseudotuberculosis infection in children. Eur J Clin Microbiol Infect Dis. 1989 Jul;8(7):587–591. doi: 10.1007/BF01968134. [DOI] [PubMed] [Google Scholar]
  24. Yli-Kerttula T., Tertti R., Toivanen A. Ten-year follow up study of patients from a Yersinia pseudotuberculosis III outbreak. Clin Exp Rheumatol. 1995 May-Jun;13(3):333–337. [PubMed] [Google Scholar]

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