Russian Journal of Skin and Venereal DiseasesRussian Journal of Skin and Venereal DiseasesРоссийский журнал кожных и венерических болезней1560-95882412-9097Eco-Vector11998310.17816/dv119983DERMATOLOGYДЕРМАТОЛОГИЯResearch ArticleReactive arthritis in coinfection with Chlamydia trachomatis and Chlamydia pneumoniaeРеактивный артрит при коинфекции Chlamydia trachomatis и Chlamydia pneumoniaehttps://orcid.org/0000-0002-1789-23117797-1699PetrovaMarina S.ПетроваМарина Сергеевна
Russian Federation

MD, research Fellow of Dermatovenereology Department

научный сотрудник отделения дерматовенерологии

marina.s.petrova@gmail.comhttps://orcid.org/0000-0003-0934-89032051-0250MolochkovaYulia VladimirovnaМолочковаЮлия Владимировна
Russian Federation

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

д.м.н., руководитель отделения дерматовенерологии, доцент кафедры дерматовенерологии и дерматоонкологии

yulia.molochkova@yandex.ruhttps://orcid.org/0000-0003-3388-92242215-1337MolochkovVladimir A.МолочковВладимир Алексеевич
Russian Federation

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

д.м.н., профессор, ведущий научный сотрудник отделения дерматовенерологии, профессор кафедры дерматовенерологии и дерматоонкологии

vmolochkov@yandex.ruhttps://orcid.org/0000-0002-2352-40802792-1126KarateevDmitry E.КаратеевДмитрий Евгеньевич
Russian Federation

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

д.м.н., заведующий отделением ревматологии, профессор кафедры терапии

dekar@inbox.ruhttps://orcid.org/0000-0002-6519-1106LuchikhinaElena L.ЛучихинаЕлена Львовна
Russian Federation

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

к.м.н., ведущий научный сотрудник отделения ревматологии, доцент кафедры терапии

eleluch@yandex.ruhttps://orcid.org/0000-0003-4140-10142436-2330SkirdaTatiana А.СкирдаТатьяна Александровна
Russian Federation

MD, Leading Researcher

к.м.н., ведущий научный сотрудник лаборатории кокковых инфекций

t.skirda@mail.ruhttps://orcid.org/0000-0002-2799-32987286-9901IsaevVasif MusaИсаевВасиф Муса оглы
Russian Federation

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

д.м.н., профессор кафедры оториноларингологии ФУВ

isaevlor@gmail.comMoscow Regional Research and Clinical InstituteМосковский областной научно-исследовательский клинический институт имени М.Ф. ВладимирскогоG.N. Gabrichevsky Research Institute for Epidemiology and MicrobiologyМосковский научно-исследовательский институт эпидемиологии и микробиологии имени Г.Н. Габричевского08042023210520232621811920501202311032023Copyright ©; 2023, Eco-VectorCopyright ©; 2023, Эко-Вектор2023Eco-VectorЭко-Векторhttps://eco-vector.com/for_authors.php#07https://rjsvd.com/1560-9588/article/view/119983

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.

Приведённый случай развития реактивного артрита на фоне коинфекции Chlamydia trachomatis и Chlamydia рneumoniae интересен особенностями клинической картины, длительностью течения, сложностью диагностики, лабораторным наблюдением, комплексным подходом к терапии.

Реактивный артрит относится к группе серонегативных спондилоартритов, имеет разнообразную симптоматику с поражением различных органов и систем. У всех пациентов имеется патология периферических суставов и/или осевого скелета. Заболевание носит иммуновоспалительный характер, может последовать за инфекцией мочеполового или пищеварительного тракта. Особая роль в развитии урогенного реактивного артрита отводится C. trachomatis, реже реактивный артрит вызывает C. pneumoniae. В случае персистенции инфекции, неодновременности развития или маловыраженности симптомов диагностика реактивного артрита затруднена, и примерно в одном случае из пяти заболевание приобретает хронический характер. Предрасположенность к тяжёлому течению реактивного артрита может обусловливать наличие у пациента антигена HLA-B27. Можно предполагать, что коинфекция двух разновидностей хламидий (С. pneumoniae и C. trachomatis) может действовать синергично, повышая риск развития реактивного артрита.

Представленный в статье собственный успешный опыт лимфотропной антибиотикотерапии в комплексном лечении пациента основан на имеющихся в специализированной литературе данных по эффективности противохламидийных препаратов.

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