 |
MR Vol.10 No.1 indexに戻る
 |
MODERN RHEUMATOLOGY
Vol.10 No.1 |
 |
|
|
 |
|
|
A boy with erosive arthritis during treatment
of severe group-A streptococcal infection
|
|
|
| Y. Wada, M. Kubo |
(1)Department of Pediatrics, Tokyo Jikei University
School of Medicines, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo,
Japan
(2)Department of Pediatrics, Kashiwa Hospital, Tokyo, Japan |
| |
| Abstract |
| Abstract The patient was admitted to our department
with major complaints of fever, swelling of the left thigh, and a
cognition disorder. A blood culture yielded type T1, toxin-B-positive
group-A streptococcus. Magnetic resonance imaging of the left foot
showed fasciitis. Severe group-A streptococcal infection was diagnosed,
and the administration of antibiotics, a massive dosage of gamma-globulin,
and a steroid preparation were prescribed, which resulted in a general
improvement in the symptoms and reductions in the swelling of the
left foot and the second finger of the left hand without any sequelae.
Following discharge from the hospital, however, destruction of the
joint of the first toe of the right foot was recognized. A number
of cases of post-streptococcal reactive arthritis (PSRA) have recently
been reported, and the pathogenicity of this arthritis, which is
different from that of rheumatic fever, has been noted. Severe group-A
streptococcal infections, such as the one described here, may develop
into erosive arthritis after the symptoms, that affect several organs,
have disappeared. We believe that because it is possible for post-streptococcal
reactive arthritis to develop, one should be aware of this when dealing
with all clinical patients who have streptococcal infections. |
| |
| Key words |
| Key words Toxic shock-like syndrome ・ Group-A
streptococcal infection ・ Erosive arthritis ・ Reactive arthritis |
|
|
 |
|
|
