Reactive arthritis secondary to Hafnia alvei enterocolitis

© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ..

Diagnosis of postenteritic reactive arthritis (ReA) is a challenge and might have a broad range of differential diagnoses. A 50-year-old man was referred to our attention because of persistent inflammatory low back pain and asymmetric oligoarthritis. The clinical history was positive for diarrhoea in the previous 3 months. Inflammatory bowel disease, Whipple and celiac diseases were carefully excluded. In addition, serology, stool cultures, biopsies from the upper gastrointestinal tract yielded negative results for infections. A presumptive diagnosis of ReA was done and a non-steroidal anti-inflammatory drug trial prescribed. Persistence of symptoms prompted us for a second look of the colon. Biopsy collected from the terminal ileum were cultured and surprisingly colonies of Hafnia alvei, a rod-shaped Enterobacteriaceae, were detected. Treatment with ciprofloxacin leads to fast symptoms resolution. Although enterocolitis from H. alvei has been rarely reported, the culture of intestinal specimens might be recommended in the work-up of patients with suspected postenteritic ReA.

Media Type:

Electronic Article

Year of Publication:

2019

Contained In:

BMJ case reports - Vol. 12, No. 5 (2019)

Language:

English

Contributors:

Erre, Gian Luca
Colombo, Enrico
Bibbò, Stefano
Dore, Maria Pina

Urls:

Volltext

Keywords:

*Hafnia alvei
5E8K9I0O4U
Anti-Bacterial Agents
Arthritis, Reactive
Case Reports
Ciprofloxacin
Diagnosis, Differential
Drug Administration Schedule
Drug Therapy, Combination
Enterobacteriaceae Infections
Enterocolitis
Humans
Infectious diseases
Journal Article
Male
Middle Aged
Probiotics
Radionuclide Imaging
Rheumatology
Treatment Outcome

Notes:

Date Completed 16.12.2019

Date Revised 06.08.2020

published: Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1136/bcr-2018-228513

PMID:

31142484

PPN (Catalogue-ID):

NLM298193922