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Rickettsioses presenting as major joint arthritis and erythema nodosum: description of four patients

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Abstract

Erythema nodosum and aseptic arthritis are recognized associations of rickettsial infections. However, they usually present with a febrile illness rather than with severe arthritis. We report three patients who presented with incapacitating major joint arthritis and one who presented with severe spondyloarthropathy in addition to major joint arthritis due to serologically confirmed Orientia tsutsugamushi and Rickettsia conorii infections. All of them had erythema nodosum and low-grade fever. They had rapid clinical response to doxycycline.

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Authors and Affiliations

  1. Department of Medicine, Faculty of Medicine, University of Kelaniya, P.O. Box 6, Thalagolla Road, Ragama, Sri Lanka

    R. Premaratna & H. J. de Silva

  2. Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

    T. G. A. N. Chandrasena

  3. Department of Microbiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

    N. K. B. K. R. G. W. Bandara

  4. Faculty of Veterinary Medicine, University of Peradeniya, Peradeniya, Sri Lanka

    R. P. V. J. Rajapakse

  5. Rickettsial Zoonosis Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA

    M. E. Eremeeva & G. A. Dasch

Authors
  1. R. Premaratna
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  2. T. G. A. N. Chandrasena
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  3. R. P. V. J. Rajapakse
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  4. M. E. Eremeeva
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  5. G. A. Dasch
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  6. N. K. B. K. R. G. W. Bandara
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  7. H. J. de Silva
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Corresponding author

Correspondence to R. Premaratna.

Additional information

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the United States Department of Health and Human Services or the Centers for Disease Control and Prevention.

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Premaratna, R., Chandrasena, T.G.A.N., Rajapakse, R.P.V.J. et al. Rickettsioses presenting as major joint arthritis and erythema nodosum: description of four patients. Clin Rheumatol 28, 867–868 (2009). https://doi.org/10.1007/s10067-009-1166-3

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  • DOI: https://doi.org/10.1007/s10067-009-1166-3

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