Herrlinger J D, Wuthe H H
Med Klin. 1979 Nov 9;74(45):1681-5.
Clinical picture and differential diagnosis of Yersinia arthritis are shown by means of three own observations. It is an acute oligoarthritis affecting especially knee- and ankle-joints. The involved joints are very painful, swollen and warm. There may be a history of enteritis or suspicion of acute appendicitis because of lower abdominal pain, but this is not obligatory. The laboratory parameters of inflammation (ESR, C-reactive protein, white blood count, serumproteinelectrophoresis) are changed significantly. Diagnosis is made by serum agglutination reaction (Widal-reaction) against ceesurface antigens (O-antigens) of Yersinia enterocolitica. Almost only people with the HL-A antigen B27 tend to get arthritis during Yersinia infection. The differential diagnosis has to consider reactive arthritis during Salmonella or Shigella infections, acute sarcoidosis, Reiter's disease and rheumatoid arthritis.
通过三例自身观察病例展示了耶尔森菌关节炎的临床表现及鉴别诊断。它是一种急性寡关节炎,尤其累及膝关节和踝关节。受累关节疼痛、肿胀且发热。可能有肠炎病史,或因下腹部疼痛怀疑急性阑尾炎,但并非必有。炎症实验室指标(血沉、C反应蛋白、白细胞计数、血清蛋白电泳)有显著变化。通过针对小肠结肠炎耶尔森菌菌体表面抗原(O抗原)的血清凝集反应(肥达反应)进行诊断。几乎只有携带HL - A抗原B27的人在耶尔森菌感染期间易患关节炎。鉴别诊断必须考虑沙门菌或志贺菌感染后的反应性关节炎、急性结节病、赖特综合征和类风湿关节炎。