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  • 1
    ISSN: 0340-1855
    Keywords: Schlüsselwörter ; Katzenkratzkrankheit ; reaktive Spondarthritis ; Bartonella henselae ; rheumatische Manifestationen ; Key words ; Rheumatic manifestations ; reactive spondylarthropathy ; cat scratch disease ; Bartonella henselae
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Cat scratch disease (CSD) is a rarely recognized infectious disease in Germany. Only a few years ago the causative agent, Bartonella henselae, could be isolated. The typical clinical manifestations of CSD consist of skin changes at the inoculation site and a benign lymphadenopathy; other manifestations are rare. We report the case of a 47 year old woman, who developed a reactive spondylarthropathy with synovitis of finger joints, polyarthralgias of large- and medium-sized joints, and inflammatory spinal pain after a cat bite. The rheumatic manifestations resolved after 10 months by treatment with non-steroidal antirheumatic drugs. Only a few cases of rheumatic manifestations associated with CSD have been described in the literature. Because the prevalence of Bartonella henselae infection of cats is high in Europe, rheumatic manifestations might be more frequent. Diagnosis of CSD is now improved by the development of serological tests. We provide an overview of the clinical manifestations and the diagnostic criteria.
    Notes: Zusammenfassung Bei der Katzenkratzkrankheit (KKK) handelt es sich um eine in Deutschland wenig bekannte Infektionskrankheit. Erst vor wenigen Jahren konnte der Erreger, Bartonella henselae, isoliert werden. In der Mehrzahl der Fälle findet sich ein typisches Krankheitsbild mit Hautveränderungen im Bereich von Katzenbiß- oder Kratzwunden und einer benignen Lymphadenopathie. Weniger häufig kommt es zu weiteren Organmanifestationen. Wir berichten über eine 47-jährige Patientin, die nach einem Katzenbiß eine reaktive Spondarthritis mit Synovialitiden der Fingergelenke, Polyarthralgien der mittleren und großen Gelenke und entzündliche Lumbalgien entwickelte. Die rheumatische Symptomatik war zeitlich limitiert und sprach gut auf NSAR an. Bislang sind nur wenige Fälle von Gelenkbeteiligung im Rahmen einer KKK beschrieben worden. Da die Durchseuchung von Katzen mit Bartonella henselae in Europa jedoch hoch ist, könnte es sich um eine häufigere Ursache von Gelenkbeschwerden handeln, als bislang angenommen. Die Diagnostik der KKK wurde in den letzten Jahren durch die Entwicklung serologischer Teste erleichtert. Wir geben einen Überblick über die klinischen Manifestationen und fassen die diagnostischen Kriterien dieser Erkrankung zusammen.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1434-9949
    Keywords: Early Arthritis ; Undifferentiated Arthritis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Diagnosis of arthritis with recent onset is still an unresolved problem. In 1984 we started an outpatient clinic for patients with early arthritis of less than one year duration. Of a total of 226 patients seen 149 (66%) had definite (n=76; 34%) or probable (n=73; 32%) inflammatory rheumatic disease, and 77 (34%) had degenerative or extraarticular rheumatic disease. Thirtynine patients were classified as undifferentiated arthritis. This undefined arthritis was often monoarticular (12%) and oligoarticuler (44%). One patient met 5 ARA-criteria for rheumatoid arthritis, 14 (36%) met 3–4 ARA-criteria and 25 (64%) only 1–2 ARA-criteria. ESR was elevated in only 23 (59%) patients, rheumatoid factor was positive in 7 (19%) patients and HLA-B27 was positive in 9 (23%) patients. Seventeen (44%) patients had a history of recent infections preceding the beginning of joint symptoms. Thus undifferentiated arthritis represents a heterogeneous group of diseases. Despite diagnostic progresses in recent years a high proportion of early arthritis cannot be diagnosed definitely.
    Type of Medium: Electronic Resource
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