Arthritis Associated with Yersinia Enterocolitica Infection

Summary

During a three-month period in 1968,3875 sera sent in for rheumatoid factor tests were screened for agglutinating antibodies against two Yersinia enterocolitica serotypes. Nineteen of the 46 patients with a titer of 160 or higher had polyarthritis with acute onset. Of the remaining 27 patients 11 had erythema nodosum and eight febrile diarrhea, usually associated with some symptoms in joints. Most of the 19 patients with polyarthritis had preceding fever and gastrointestinal symptoms. Fingers, knees and ankles were most often affected. Three patients had acute sacro-iliitis and some others back pain or severe myalgia. In the initial phase the tests for rheumatoid factors were negative in all 19 cases. Mean ESR was 79 mm/hour in the acute phase. A significant reduction in the Y.enterocolitica titer took place within three months in every case. The duration of the arthritis was from one week to five months in the 15 cases in which the arthritis subsided during the follow-up period of eight to eleven months. Five of the patients with arthritic complaints had urinary symptoms or signs, and three of them also had conjunctivitis. In addition, two patients had acute iritis. It is concluded that nonpurulent polyarthritis may be associated with Y.enterocolitica infections. The differentiation of this type of arthritis from rheumatic fever and, if protracted, from rheumatoid arthritis, is important.