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J Infect Chemother ; 24(7): 531-537, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29606414


Reactive arthritis after Group A streptococcal infection (poststreptococcal reactive arthritis: PSRA) that does not meet the Jones criteria for acute rheumatic fever (ARF) has been reported as a new entity for over a decade. In Japan there are few reports of PSRA. We encountered four children with arthritis accompanied with Group A streptococcal infection in our department. We investigated our cases and the recent Japanese literature. Japanese cases of PSRA are frequently accompanied with uveitis and erythema nodosum, and tonsillectomy resolved their symptoms in some cases. There were overlap cases between ARF, juvenile idiopathic arthritis, and PSRA.

Artritis Juvenil/diagnóstico por imagen , Artritis Reactiva/diagnóstico por imagen , Artritis Reactiva/microbiología , Infecciones Estreptocócicas/complicaciones , Adolescente , Antibacterianos/uso terapéutico , Artritis Juvenil/microbiología , Artritis Reactiva/tratamiento farmacológico , Biomarcadores/sangre , Niño , Preescolar , Quimioterapia Combinada , Eritema Nudoso , Femenino , Humanos , Japón , Masculino , Fiebre Reumática/diagnóstico por imagen , Fiebre Reumática/microbiología , Infecciones Estreptocócicas/tratamiento farmacológico , Tonsilectomía , Uveítis
J Infect Chemother ; 21(8): 610-2, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25960155


BACKGROUND: Acute rheumatic fever (ARF) is an illness caused by group A streptococcus (GAS) infection, and remains the leading cause of acquired heart disease in worldwide. Distinguishing between ARF and septic arthritis may be difficult. This report describes a case of suppurative arthritis overlapping with ARF. CASE PRESENTATION: A 4-year-old, previously healthy boy presented with fever and left leg pain. The level of anti-streptolysin O (ASO) was elevated. His throat swab cultures grew GAS, but none were detected in his synovial fluid. Magnetic resonance imaging revealed suspected arthritis and osteomyelitis. The patient was treated for septic arthritis, but was subsequently diagnosed with ARF, after the development of carditis. CONCLUSION: The clinical and laboratory features of ARF and suppurative arthritis demonstrate substantial overlap. Patients with an elevated ASO should undergo a careful cardiac examination for carditis associated with ARF by an echocardiogram.

Artritis Infecciosa/diagnóstico , Artritis Juvenil/diagnóstico , Osteomielitis/diagnóstico , Fiebre Reumática/diagnóstico , Fiebre Reumática/tratamiento farmacológico , Infecciones Estreptocócicas/complicaciones , Streptococcus pyogenes/aislamiento & purificación , Enfermedad Aguda , Artritis Infecciosa/microbiología , Artritis Juvenil/microbiología , Preescolar , Diagnóstico Diferencial , Humanos , Masculino , Miocarditis/microbiología , Osteomielitis/microbiología , Fiebre Reumática/microbiología , Infecciones Estreptocócicas/tratamiento farmacológico