Reactive arthritis in coinfection with Chlamydia trachomatis and Chlamydia pneumoniae

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Abstract

The below case of the development of reactive arthritis against the background of coinfection of Chlamydia trachomatis and Chlamydia pneumoniae is interesting by the features of the clinical picture, the duration of the course, the complexity of diagnosis, laboratory observation, and a comprehensive approach to therapy.

Reactive arthritis belongs to the group of seronegative spondyloarthritis, has a variety of symptoms with damage to various organs and systems. All patients have pathology of peripheral joints and/or axial skeleton. The disease is immuno-inflammatory in nature, may follow an infection of the genitourinary or digestive tract. A special role in the development of urogenic reactive arthritis is assigned to Chlamydia trachomatis. Less often, reactive arthritis is caused by C. pneumoniae. In the case of persistent infection, non-simultaneous development or low expression of symptoms, the diagnosis of reactive arthritis is difficult, and in about one case out of five, the disease becomes chronic. Predisposition to severe course of reactive arthritis may cause the presence of HLA-B27 antigen in the patient. It can be assumed that coinfection of two varieties of chlamydia (C. pneumoniae and C. trachomatis) can act synergistically, increasing the risk of developing reactive arthritis.

The available data on the effectiveness of the complex of antibacterial anti-chlamydia drugs, own experience of the lymphotropic method of administration, has been successfully used in the complex treatment of the patient.

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About the authors

Marina S. Petrova

Moscow Regional Research and Clinical Institute

Email: marina.s.petrova@gmail.com
ORCID iD: 0000-0002-1789-2311
SPIN-code: 7797-1699

MD, research Fellow of Dermatovenereology Department

Russian Federation, 61/2 Shepkina street, 129110 Moscow

Yulia Vladimirovna Molochkova

Moscow Regional Research and Clinical Institute

Email: yulia.molochkova@yandex.ru
ORCID iD: 0000-0003-0934-8903
SPIN-code: 2051-0250

MD, PhD, Head of department of Dermatovenereology, accociate professor of Chair of Dermatovenereology and Dermatooncology

Russian Federation, 61/2 Shepkina street, 129110 Moscow

Vladimir A. Molochkov

Moscow Regional Research and Clinical Institute

Email: vmolochkov@yandex.ru
ORCID iD: 0000-0003-3388-9224
SPIN-code: 2215-1337

MD, PhD, Professor, Merited Scientist, Leading researcher, Professor of Chair of Dermatovenereology and Dermatooncology of Doctors Improvement Faculty

Russian Federation, 61/2 Shepkina street, 129110 Moscow

Dmitry E. Karateev

Moscow Regional Research and Clinical Institute

Email: dekar@inbox.ru
ORCID iD: 0000-0002-2352-4080
SPIN-code: 2792-1126

MD, PhD, Head, Department of Rheumatology, Professor, Department of Therapy

Russian Federation, 61/2 Shepkina street, 129110 Moscow

Elena L. Luchikhina

Moscow Regional Research and Clinical Institute

Email: eleluch@yandex.ru
ORCID iD: 0000-0002-6519-1106

MD, PhD, Leading Researcher, Department of Rheumatology, Associate Professor, Department of Therapy

Russian Federation, 61/2 Shepkina street, 129110 Moscow

Tatiana А. Skirda

G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology

Email: t.skirda@mail.ru
ORCID iD: 0000-0003-4140-1014
SPIN-code: 2436-2330

MD,  Leading Researcher

Russian Federation, 10 st. Admiral Makarov, Moscow

Vasif Musa Isaev

Moscow Regional Research and Clinical Institute

Author for correspondence.
Email: isaevlor@gmail.com
ORCID iD: 0000-0002-2799-3298
SPIN-code: 7286-9901

MD, Dr. Sci. (Med.), Professor

Russian Federation, 61/2 Shepkina street, 129110 Moscow

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2. Fig. 1. X-ray of the paranasal sinuses. There is a subtotal veiling of the left maxillary sinus in the naso-chin projection. Pneumatization of the remaining sinuses is preserved. The nasal passages are narrowed due to mucosal edema. Conclusion: Left-sided catarrhal sinusitis, rhinitis.

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3. Fig. 2. X-ray of the pelvis. Signs of bilateral sacroiliitis, more expressed on the right (grade II on the right, I–II on the left).

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