REACTIVE ARTHRITIS-ASSOCIATED WITH GROUP-C AND GROUP-G BETA-HEMOLYTICSTREPTOCOCCI

Objective, Group A beta-hemolytic streptococci (GAS) are known to be c apable of evoking sterile arthritis. Reactive arthritis (ReA) has been reported sporadically following primary infection with group C and gr oup G beta-hemolytic streptococci (GCS, GGS). We prospectively studied 4 cases of ReA secondary to throat infection with GCS and GGS. Method s. Four patients with arthritis secondary to throat infection were see n. Three patients were Dutch, one was Indonesian; female/male ratio wa s 1/3; mean age was 30 years (range 18-46). Diagnostic evaluation incl uded culture of throat swab and serological screening. Results. All pa tients presented with a nonmigratory asymmetrical arthritis: monoarthr itis in one patient, oligoarthritis in 3. Culture of throat swab was p ositive in all. Antistreptolysin-O (ASO) titer rose significantly in 2 patients, and anti-DNase-B rose in 2 patients. ASO was maximal (mean 1000 U/ml; range 890-1110) and anti-DNase-B was 395 U/ml (range 290-50 0). Treatment consisted of feneticillin for 5 days; nonsteroidal antii nflammatory drugs were prescribed on demand. All patients recovered fu lly in 3 to 12 weeks. Conclusion. These cases provide evidence of a be nign non-group A streptococcal ReA, i.e., secondary to GCS or GGS. The presence of the organism in the throat along with the elevation of an tibody to streptococcal products is important for the diagnosis of GCS /GGS associated ReA. A positive throat culture is needed for different iation from GAS associated poststreptococcal ReA, because prophylactic measures are effective only in GAS associated sequelae, but not in GC S/GGS associated ReA.