Joint manifestations of Clostridium difficile infection

BACKGROUND: Reactional joint disease subsequent to digestive tract infectio ns have been well studied for Salmonella, Shigella, Yersina and Campylobact er. Association with HLA B27 is well documented. A review of the literature since 1976 disclosed 23 cases of articular and extra-articular inflammator y reactions following pseudomembranous Clostridium difficile infection. CASE REPORT: We describe 2 new cases which followed a favorable course, Thi s is the usual outcome although inflammatory manifestations may persist or relapse. DISCUSSION: The pathophysiological interest of this condition lies in the p athogenic potential of Clostridium difficile which appears to be directly r elated to toxin production. This would suggest an immune mechanism rather t han pure infection.