PARASITIC ARTHRITIS AND PARASITIC RHEUMAT ISM

Parasitic arthritis is a rare, although probably underdiagnosed, condi tion. A wide variety of parasites can cause arthritis. The parasites c an invade the joint, either from adjacent bony or soft tissue structur es or via the bloodstream. Similar to other infectious agents, parasit es can also cause reactive arthritis (parasitic rheumatism). Clinical features vary widely. The clinical presentation is not specific to a g iven parasite but is influenced by host-related factors, including gen etic factors. Diagnosis rests on precise criteria, of which the most i mportant is the inefficacy of drugs usually given in rheumatic disease s, especially nonsteroidal antiinflammatory drugs, contrasting with th e dramatic efficacy of specific anti-parasite agents. The pathogenesis of parasitic rheumatism remains obscure. It is important that physici ans be familiar with parasitic rheumatism, since this inflammatory dis ease resolves promptly and completely under appropriate treatment. In contrast, failure to establish the diagnosis can lead to inappropriate treatments, in particular to systemic corticosteroid therapy whose ef fects can be devastating in patients with strongyloidiasis.