Presentation
The arthritis occurred after natural infection (one case) or immunisation with HPV 77 DES vaccine (six cases) and had been present for up to 6 years. [ncbi.nlm.nih.gov]
Clinical presentations of viral arthritis Virus Frequency of arthritis Typical presenting features Likelihood of presenting with arthritis Duration of arthritis Comments EBV Very low Pharyngitis, cervical lymphadenopathy Fevers Very low Days Often have [racgp.org.au]
Hepatitis C arthropathy may be present in 2 to 20 percent of patients with HCV. It generally presents as a rheumatoid-like arthritis, or as an oligoarthritis. [rheumatology.org]
Snapshot A 30-year-old woman presents to the emergency room. She is a tourist from Southeast Asia and reports having a low-grade fever for several days. She also reports having arthralgias, especially in her wrists and knees. [medbullets.com]
Viral arthritis is less common than bacterial arthritis and often the diagnosis is made in a lesser number of patients because of because of the late presentation of this condition. [boneandspine.com]
Entire Body System
- Malaise
Nonspecific constitutional symptoms may briefly antedate the rash and include malaise, fever, anorexia, upper respiratory tract infection, lymphadenopathy, and eye pain. [rheumaknowledgy.com]
[…] surveillance study of measles/mumps/rubella vaccine in Finland during 1982 to 1993 with 1.5 million pediatric and adult vaccinees reported no deaths or permanent sequelae. [ Ref ] Other side effects have included fever, syncope, headache, dizziness, malaise [drugs.com]
It is characterized by anorexia (loss of appetite), malaise, conjunctivitis, headache, and minimal respiratory symptoms. Enlarged tender lymph nodes four-ten days before rash. Viremia is evident. 3. Exanthem. [atsu.edu]
Supportive care with acetaminophen for fever and malaise is suggested. IVIG use during pregnancy for this condition is controversial. Prevention of rubella is important. [clinicaladvisor.com]
[…] have been reported during clinical trials, with use of the marketed vaccine, or with use of monovalent or bivalent vaccine containing measles, mumps, or rubella : Body As A Whole Panniculitis; atypical measles; fever; syncope ; headache; dizziness; malaise [rxlist.com]
- Anemia
CRS: CBC may show thrombocytopenia and less commonly anemia. Liver transaminases may be elevated with hepatic involvement. [infectiousdiseaseadvisor.com]
Noninvasive diagnosis by Doppler ultrasonography of fetal anemia resulting from parvovirus infection. Am J Obstet Gynecol. 2002; 187 :1290–1293. [ PubMed ] [ Google Scholar ] 61. Beersma MFC, Claas ECJ, Sopaheluakan T, Kroes ACM. [ncbi.nlm.nih.gov]
The syndrome (CRS) follows intrauterine infection by the rubella virus and comprises cardiac, cerebral, ophthalmic and auditory defects. [17] It may also cause prematurity, low birth weight, and neonatal thrombocytopenia, anemia and hepatitis. [en.wikipedia.org]
In adults, its manifestations are more protean ( Table 8 ), including symptoms such as aplastic anemia, thrombocytopenia and pancytopenia. Arthritis or arthralgia occur in about 8% of juvenile and 60% of young adult patients. [antimicrobe.org]
Cardiovascular
- Heart Disease
disease Prevention measles, mumps, and rubella (MMR) vaccine given over 2 doses Prognosis infection may be asymptomatic but still contagious Presentation Symptoms low-grade fever polyarthritis and polyarthralgia more common in adult females fingers, [medbullets.com]
The virus was isolated in 1962, and a vaccine became available in 1969 an illness that can cause birth defects, including congenital heart disease, if a woman contracts it for the first time during pregnancy; can be prevented by immunization with the [seslisozluk.net]
Congenital heart disease rubella ) 4. Mental retardation ) 5. Deafness syndrome ) 6. Purpura DIAGNOSIS : 1. History of rubella during first trimester of pregnancy. 2. Isolation of rubella virus from fluid obtained by amniocentesis. 3. [atsu.edu]
Pediatric Cardiology should be consulted to assess and treat congenital heart disease, and Pediatric Neurology can help in managing immediate CNS symptoms, such as encephalitis and seizures. [infectiousdiseaseadvisor.com]
Some common manifestations of congenital rubella syndrome include: deafness; eye problems, including cataracts and glaucoma; congenital heart disease; mental retardation; and many others. [deafblind.com]
- Hypertension
CASE 2 A 65 year-old male with past history of hypertension, obesity and benign prostatic hypertrophy is evaluated for a 2 day history of acute pain and swelling of his right knee. [rheumatology.org]
Skin
- Erythema
الصفحة 129 - Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds Erythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions Skin rash as [books.google.com]
Applies to rubella virus vaccine : subcutaneous powder for injection Local Local side effects have included injection site burning/stinging, wheal and flare, erythema, pain, and induration. [ Ref ] Hypersensitivity Hypersensitivity reactions have included [drugs.com]
Skin Stevens-Johnson syndrome ; erythema multiforme ; urticaria ; rash; measles-like rash; pruritis. [rxlist.com]
ReA=Reactive Arthritis; HIV=Human Immunodeficiency Virus; Gc=Gonococcal; EN=Erythema Nodosum; EM=Erythema Migrans. [antimicrobe.org]
Skin Stevens-Johnson syndrome; erythema multiforme; urticaria; rash; measles-like rash; pruritis. local reactions including burning/stinging at injection site; wheal and flare; redness (erythema); swelling; induration; tenderness; vesiculation at injection [immunizationalternatives.com]
- Ulcer
Erythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions Skin rash as a result of unusual reaction to sunlight, by patient history or physician observation Oral or nasopharyngeal ulceration [books.google.com]
Cutaneous lesions (nodules, ulcers, draining sinus tracts) occur frequently. These infections occur late in the course of HIV infection, as also fungal infections, which also can cause septic arthritis. [antimicrobe.org]
The diagnosis of arthritis in HCV-associated mixed cryoglobulinemia requires the recognition of a combination of clinical (purpura, membranoproliferative glomerulonephritis, peripheral neuropathy, and skin ulcers), serologic (type II or III cryoglobulins [arthritis-research.biomedcentral.com]
[PubMed] Gilat T, Hacohen D, Lilos P, Langman MJ (1987) Childhood factors in ulcerative colitis and Crohn’s disease. An international co-opreative study. Scan J Gastroenterology 22 : 1009–24. [CrossRef] Gillberg C, Heijbel H (1998) MMR and autism. [pcouk.org]
- Skin Rash
الصفحة 129 - Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds Erythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions Skin rash as [books.google.com]
Sore throat and fever are followed by swollen glands and a rash. Up to 30% of infections may have no symptoms. Lifelong immunity follows infection. Encephalitis is a rare complication. [seslisozluk.net]
She noticed a skin rash over her face which resolved after 4 days. Her joints still continue to ache, particularly her fingers, wrists, and feet. Past medical history and family history is unremarkable. [rheumatology.org]
rash - Purpura - Prodromal phase lasting 1 week with flu-like symptoms prior to arthritis - Fever - Vasculitis - Fever - Peripheral neuropathy - Skin rash ( - Skin rash - Sjögren-like syndrome - Myalgias - Glomerulonephritis - Myalgias - Skin ulcers [arthritis-research.biomedcentral.com]
- Skin Disease
Centers for Disease Control and Prevention. Arthritis Basics. Available online at https://www.cdc.gov/arthritis/basics/index.html. Accessed January 2020. National Institute of Arthritis and Musculoskeletal and Skin Diseases. [labtestsonline.it]
Miscellaneous Sarcoidosis (a condition that forms inflammatory cells that affect the lungs skin and lymph nodes) Fibromyalgia Polymyalgia rheumatic Sweet’s Syndrome/Wells Syndrome (skin diseases indicated by sudden fever, elevated white blood cell count [jointhealthmagazine.com]
Previously, HIV infected patients often developed severe psoriasis-like skin disease and also psoriatic arthritis. [antimicrobe.org]
- Skin Lesion
This patient has disseminated gonococcal infection (DGI) with classic symptoms of tenosynovitis, characteristic skin lesions and a migratory polyarthritis. [rheumatology.org]
In the absence of tenosynovitis or skin lesion, the clinical features of the gonococcal may mimic those of nongonococcal septic arthritis caused for instance by Staphylococcus aureus. [antimicrobe.org]
Musculoskeletal
- Arthritis
These data do not support a direct role for raised CIC levels in the pathogenesis of rubella-associated arthritis or arthralgia. [ncbi.nlm.nih.gov]
viral arthritis, viral arthritis (diagnosis), Arthritis viral NOS, Arthritis;viral, Arthritis viral, Arthritis due to viral infection, Viral arthritis, Arthritis due to viral infection (disorder), Arthritis, Viral Dutch virale artritis, artritis viraal [fpnotebook.com]
- Migratory Polyarthritis
This patient has disseminated gonococcal infection (DGI) with classic symptoms of tenosynovitis, characteristic skin lesions and a migratory polyarthritis. [rheumatology.org]
Indeed, migratory polyarthritis is one of the five major manifestations of rheumatic fever ( Table 6 ), whose diagnostic criteria (the Jones criteria) have been updated in 1992. Table 6. [antimicrobe.org]
- Bilateral Knee Effusion
Joint examination: Positive for heberdon’s and bouchard’s nodes at DIP’s and PIP’s bilaterally. The right knee is swollen, warm and painful with flexion and extension. Left knee reveals crepitus on extension, no effusion. Other joints are normal. [rheumatology.org]
Workup
Workup Laboratory Studies Parvovirus B19 The incubation period for parvovirus B19 is 7-18 days, and the state of viremia lasts 5-6 days. [emedicine.medscape.com]
The family history, after a very extensive workup, on both sides is totally negative for autism and the mother's chromosomal studies were normal." In the following case, Dr. [forums.prohealth.com]
Microbiology
- Chlamydia
Other less frequently diagnosed infections in association with reactive arthritis are Campylobacter lari and Chlamydia psittacii. Chlamydia pneumoniae, a respiratory pathogen, is the triggering agent in about 10% of patients with reactive arthritis. [antimicrobe.org]
Inflammatory bowel disease In the acute phase, microbiological studies may be useful to identify the precipitating infection: Faeces MCS and antigen ( Salmonella, Shigella, Campylobacter, Yersinia sp) ; Genital swab (urethral or cervical) or urine for Chlamydia [rcpa.edu.au]
The intracellular life of chlamydiae. Semin Pediatr Infect Dis. 2002;13:239-48. FROM THE INTERNET Peng S. Non-gonococcal (septic) bacterial arthritis, MedlinePlus. [rarediseases.org]
Patients should also receive 1 gram of oral azithromycin, or doxycycline 100 mg twice a day for seven days to cover potential Chlamydia. trachomatis co-infection. Treatment of sexual partners is also recommended. References: 1.P.A. [rheumatology.org]
- Staphylococcus Aureus
Bacteria Which Are Most Commonly Isolated from Synovial Fluid of Patients with Bacterial Arthritis* Gram-positive strains Staphylococcus aureus Staphylococcus epidermidis, and other coagulase negative staphylococci Streptococci Streptococcus pyogenes [antimicrobe.org]
The most common organism implicated in septic bursitis is Staphylococcus aureus, but there is an emerging role of methicillin-resistant S. Aureus (MRSA) infections even in the community setting. [rheumatology.org]
- Neisseria Gonorrhoeae
Of the other microbes causing urethritis, there is no consensus whether Neisseria gonorrhoea can trigger reactive arthritis. [antimicrobe.org]
Patients suspected of DGI should also have urethral, cervical and/or rectal cultures submitted to increase the yield of isolating Neisseria gonorrhoea. [rheumatology.org]
HLA Type
- HLA-B27
Connective tissue disease, especially SLE Seronegative arthritis, especially Ankylosing spondylitis Rheumatoid factor-negative spondylo-arthropathies associated with HLA-B27. [rcpa.edu.au]
The role of HLA-B27 in this process has been discussed, and the favorite hypothesis is a cross-reaction between microbial structures and HLA-B27, or that HLA-B27 itself might be a target of immune response. [antimicrobe.org]
Individuals genetically prone to develop autoimmune illness (namely carriers of HLA-DR1, DR4, DR6, or HLA-B27) are more likely to contract post-immunization arthritis. [encognitive.com]
Treatment
A similar approach is taken to the treatment of bacterial infection. Discussions of pathophysiology are intertwined with discussions of diag nostic techniques, prevention techniques and treatment of bacterial in fections. [books.google.de]
Evans J, et al: Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease. الصفحة 173 - Dalakas MC, Illa I, Dambrosia JM et al. [books.google.com]
Treatment of psoriasis in adults. In Dellavalle RP, Duffin, KC, ed. UpToDate. Updated February 26, 2021. Accessed June 6, 2021. https://www.uptodate.com/contents/treatment-of-psoriasis-in-adults Gladman DD, and Ritchlin C. [labtestsonline.it]
Treatment of Viral Arthritis Viral arthritis is mild and requires only symptomatic treatment. NSAIDs, low dose steroids are mostly used. Antiviral drugs are used when indicated. [boneandspine.com]
Intravenous treatment for two weeks to one month is the CDC’s recommended treatment duration References and further reading: Eugene D. Shapiro, M.D. Lyme Disease; N Engl J Med 2014; 370:1724-1731 http://www.cdc.gov/lyme 6) The correct answer is C. [rheumatology.org]
Prognosis
Postnatal Infection: Patients with rubella infection have an excellent prognosis. Exceptions include patients with encephalitis in which prognosis is related to the severity and extent of encephalitis. [infectiousdiseaseadvisor.com]
The long-term prognosis for recovery is poor, meaning, the damage can be permanent. Subscribe to the NewsWithViews Daily News Alerts! As stated by Dr. [newswithviews.com]
[…] congenital rubella syndrome Associated conditions congenital rubella syndrome blueberry muffin appearance dermal extramedullary hematopoiesis cataracts deafness congenital heart disease Prevention measles, mumps, and rubella (MMR) vaccine given over 2 doses Prognosis [medbullets.com]
Prognosis and outcome Maternal outcome is routinely uncomplicated. However, CRS can lead to significant morbidity in the fetus. The sequelae associated with CRS most commonly are associated with hearing loss (67%). [clinicaladvisor.com]
Interpersonal And Communication Skills Explain the evaluation, diagnosis, treatment and prognosis clearly to patient and family, using a patient-centered approach. [rheumatology.org]
Etiology
In this analysis, etiologic mechanisms for chronic arthritis following adult rubella and Hepatitis B vaccines were also explored. [vaccines.me]
Persistence of rubella virus in lymphoreticular cells in 35 per cent of these cases of juvenile arthritis supports the view that the virus may be an etiologic agent in chronic human joint disease, but further work will be required to support this suggestion [nejm.org]
Etiology: Chronic rubella arthritis is caused by infection with an RNA virus. The rubella virus has been isolated from synovial fluid and peripheral blood. [rheumaknowledgy.com]
MM 499-502; ID 903-911 NAME OF DISEASE : Rubella German measles Three-day measles ETIOLOGICAL AGENT : The rubella virus (a togavirus), contains RNA and an envelope. It replicates in the cytoplasm. EPIDEMIOLOGY : Man is only host. [atsu.edu]
PMCID: PMC111599 Rubella virus (RV), the etiologic agent of German measles, belongs to the family Togaviridae and is the only member of the genus Rubivirus. [explorevaccines.wordpress.com]
Epidemiology
The volume includes a remarkably fresh and interesting discussion of viral diseases as they affect the nervous system, including conventional and unconventional virus agents, and in addition, discussions of path ophysiology and epidemiology and postinfectious [books.google.de]
Annual updates on rubella incidence are published in ECDC’s Annual epidemiological report on communicable diseases in Europe. The 2013 report is available here. [ecdc.europa.eu]
Rubella vaccination and epidemiology : Cherry, J.D. “The ‘new’ epidemiology of measles and rubella.” Hospital Practice (July 1980), p. 55. CDC. “Rubella and congenital rubella syndrome—United States, 1985-1988. MMWR 1989; 38:173-178. CDC. [vaccineinjury.info]
Epidemiology and Prevention of Vaccine-Preventable Diseases (12 ed.). Public Health Foundation. pp. 301–323. ISBN 9780983263135. Archived from the original on 2017-05-01. [en.wikipedia.org]
Molecular epidemiological study of rubella virus genotype could reveal the transportation of rubella virus from a country to another country. [explorevaccines.wordpress.com]
Pathophysiology
Discussions of pathophysiology are intertwined with discussions of diag nostic techniques, prevention techniques and treatment of bacterial in fections. [books.google.de]
Epstein-Barr virus Usually polyarthralgia but may cause arthritis Varicella-zoster virus Mumps virus Adenovirus or coxsackieviruses A9, B2, B3, B4, and B6 Cause polyarthritis, pleuritis, myocarditis Echovirus Pathophysiology Viral infection is dependent [boneandspine.com]
Here, we review the epidemiology, the pathophysiological mechanisms, the pertinent clinical and laboratory findings as well as the principles of therapy of the most common virus-associated arthritides. [arthritis-research.biomedcentral.com]
Prevention
Additional surgical problems are discussed regarding prevention and management of peri operative infection and brain abscess. [books.google.de]
Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization [books.google.com]
Centers for Disease Control and Prevention. Arthritis Types. Available online at http://www.cdc.gov/arthritis/basics/types.htm. Accessed Sept 2013. Centers for Disease Control and Prevention. Childhood Arthritis. [labtestsonline.it]
Epidemiology and Prevention of Vaccine-Preventable Diseases (10th ed.). Centers for Disease Control and Prevention. Archived from the original on 2007-06-20. Retrieved 2007-07-03. ^ a b c d "Chapter 11 — Rubella" (PDF). Immunisation Handbook 2006. [en.wikipedia.org]
The MMR vaccine, introduced in the United States in 1971, helps prevent the measles, the mumps, and rubella (German measles). This vaccine was a huge development in the battle to prevent these dangerous diseases. [healthline.com]