Clostridium difficile infection in patients with reactive arthritis of undetermined etiology.

In this study Clostridium difficile infection, which has been reported to induce reactive arthritis (ReA), was investigated in patients with ReA of undetermined etiology. One hundred patients with acute arthritis were included to in the study. The diagnosis of arthritis and/or infectious agents that are capable of causing ReA were determined in 69 of them. The remaining 31 patients (study group) with ReA of undetermined etiology were further investigated for C. difficile Toxin A (CDTA). The control groups were consisted of hospitalized patients and outpatients who had no history of diarrhea, arthritis, and antibiotic use. CDTA positive patients (19.4% of the study group) were treated only with oral vancomycin and evaluated for the prognosis of diarrhea and/or arthritis. The results strongly suggested C. difficile infection can induce ReA, especially in patients with antibiotic-associated colitis.