Poststreptococcal arthritis in teenagers

Abstract

During 1995-1999 autumn-winter periods 300 teenagers with signs of acute respiratory disease (ARD) were examined. 38% from them had group A p-hemolytic streptococcus (GABS) and elevation of anti- streptolysine-O antibodies titers what comply with definite streptococcal infection criteria. Arthritis was revealed and immunologically characterized in 35 teenagers with streptococcal pharyngitis. Pts with non streptococcal pharingitis did not have arthritis. These results allowed to describe clinical and immunological signs of poststreptococcal arthritis for the first time in our land. These signs included asymmetrical non migrating arthritis lasting from 8 to 156 days with primary involvement of large (knee) and less frequently - small joints. Synovitis manifested with joint pain and swelling. It was confirmed by US examination and differed from migrating arthritis in acute rheumatic fever (ARF). According to WHO recommendations teenagers with definite streptococcal infection received combined treatment - single injection of bicillin-5 with subsequent treatment with fenoximethylpenicilline. Cultures and blood immunologic examination in a month and later after treatment gave negative results in 90,5% of pts. Described disease or syndrome associated with acute upper respiratory infection in teenagers differ from ARF.

Keywords

• poststreptococcal arthritis
• teenagers