Adult-onset poststreptococcal reactive arthritis: a case report

Abstract

Poststreptococcal reactive arthritis （PSRA） refers to reactive arthritis after Group A streptococcal （GAS） infection that does not meet the diagnostic criteria for acute rheumatic fever （ARF）. It is rare in clinical practice and prone to misdiagnosis due to the lack of characteristic symptoms and signs in the early stage of PSRA. In this article， an adult male patient with PSRA was reported， showing recurrent swelling and pain on the back of the right foot and the medial malleolus. The onset process of the patient was suspected of gout. He received the treatment of reducing uric acid and relieving pain in a local hospital， which was ineffective. The patient was finally diagnosed with PSRA because of the history of pharyngitis and elevated levels of C-reactive protein and antistreptolysin O （ASO） through detection. He received long-term use of benzathine benzylpenicillin combined with anti-inflammatory and analgesic therapy. Subsequently， the condition was improved and no recurrence occurred during follow-up. The diagnosis and treatment of this case prompt that for patients with recurrent arthritis， the possibility of PSRA should be considered. Extensive attention should be paid to differential diagnosis and treatment between gout and reactive arthritis.

Keywords

• |reactive arthritis|streptococcus|acute rheumatic fever|penicillin|gout