Department of Infectious Diseases, Aarhus Universitet, Aarhus, Denmark
Department of Internal Medicine, Randers Regional Hospital, Randers, Midtjylland, Denmark.
BMJ Case Rep. 2021 Mar 2;14(3):e241375. doi: 10.1136/bcr-2020-241375.
A previously healthy 53-year-old man was hospitalised for 12 days due to COVID-19 with shortness of breath. A few days after discharge from hospital, the patient developed fever and severe pain in several joints in the lower extremities. The pain was so severe that the patient was unable to stand on his feet. Synovial fluid from the right-side knee contained a high number of polynuclear cells and a few mononuclear cells. Microscopy, culture and PCR tests for bacterial infection were all negative. Furthermore, the patient tested negative for rheumatoid factor, anti-cyclic citrullinated peptide and human leukocyte antigen (HLA)-B27. Thus, the condition was compatible with reactive arthritis. The condition improved markedly after a few days' treatment with non-steroid anti-inflammatory drugs and prednisolone.
一位 53 岁既往健康的男性因 COVID-19 导致呼吸急促住院 12 天。出院几天后,患者出现发热和下肢多个关节严重疼痛。疼痛非常剧烈,患者无法站立。右侧膝关节滑液中含有大量多核细胞和少数单核细胞。细菌感染的显微镜检查、培养和 PCR 检测均为阴性。此外,患者类风湿因子、抗环瓜氨酸肽和人类白细胞抗原(HLA)-B27 检测均为阴性。因此,该病症符合反应性关节炎。经非甾体抗炎药和泼尼松龙治疗数天后,病情明显改善。