Reactive arthritis associated with Campylobacter enteritis

Campylobacter jejuni has recently become recognized as a leading cause of diarrhea. To date reactive arthritis has rarely been diagnosed in association with Campylobacter enteritis. Clinical manifestations, diagnostic studies and management of 21 patients with Campylobacter-reactive arthritis are reviewed. The symptom-free interval between diarrhea and arthritis lasts from a few days to several weeks. In two-thirds of the patients sterile joint involvement is multiple, is migratory and includes large joints. Fever and leukocytosis are usually absent, whereas the erythrocyte sedimentation rate is elevated. Positive association with HLA-B27 is found in approximately 60% of cases. Arthritic course is self-limiting and ranges from one week to several months, and prognosis is excellent. These features of Campylobacter-reactive arthritis are consistent with those of reactive arthritis associated with Salmonella, Shigella or Yersinia intestinal infection.