Poststreptococcal Reactive Arthritis: Report of One Case

鏈球菌引致反應性關節炎(poststreptococcus reactive arthritis)代表著一群鏈球菌感染後，雖合併有反應性關節炎卻不完全符合修正Jones標准的病人，而最近的研究指出，罹患鏈球菌反應性關節炎的病人以後轉變爲風濕性心臓前不見古人的機會與急性風濕熱一樣高。有些學者更指出，當鏈球菌引致之反應性關節炎出現等，也就是急性風濕熱流行的預警。近來的論文中均贊成對鏈球菌感染引致之反應性關節炎應施行預防性的抗生素治療。膝關節炎。左膝關節之抽取液爲典型的反應性關節炎表現，而咽喉培養及系列的血清學追蹤，均證實爲一急性鏈球菌感染，但其診斷條件不能完全符合修正過的Jones標准。經投給naproxen及規則性的penicillin抗生素後病人情況良好。此「鏈球菌感染後反應性關節炎」病例報告，在台灣屬首例。提出與臨床工作者分享，在遇到關節炎時應攷慮到「鏈球菌引致反應性關節炎」的可能性。

關鍵字

鍵球菌；反應性關節炎

並列摘要

Poststreptococcal reactive arthritis (PSRA) is a clinical syndrome of reacitve arthritis. It is associated with recent streptococcal infections, but could not fulfill the revised Jones criteria for acute rheumatic fever (ARF). The incidence of PSRA cardiac complications to develop was as high as the ARF’s developing into rheumatic heart disease. A 9-year-old boy presented with limping gait. He had pain in his left knee for 4 days but no fever. His right knee was swelling with a limitaion of movement. A throat culture showed positive growth for group A streptococcus, and consequently antistreptolysin-O serum titer and C-reactive protein were elevated. A synovial fluid examination was turbid but sterile. After 3 days the arthralgia subsided rapidly. A cardiac color Doppler and electrocardiogram showed no evidence of valvular disease. Under the threat of high incidence f rheumatic heart disease in PSRA, we treated this patient with prophylactic antibiotics as acute rheumatic fever. A clinic follow up one year later showed neither sequels nor heart murmur on physical examination.

並列關鍵字

Streptococcus ； poststreptococcal reactive arthritis

國際替代計量

Poststreptococcal Reactive Arthritis: Report of One Case

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