Acute Oligoarthritis Associated With Clostridium difficile Pseudomembranous Colitis

The abrupt onset of a sterile inflammatory oligoarthritis developed in a patient with active Clostridium difficile pseudomembranous colitis. The arthritis affected a hip and a knee. Leukocyte counts of synovial fluid obtained from the patient's left hip and knee were elevated. He was haplotyped as HLA-B27 antigen-positive. The colitis and arthritis promptly abated after treatment with oral vancomycin hydrochloride. Three other cases of arthritis associated with antibiotic-induced colitis were reviewed. It seems as if treatment of the colitis leads to resolution of the arthritis.