Misdiagnosis of Reactive Arthritis With Septic Arthritis in a Coronavirus Disease 2019 (Covid-19)-Positive Patient: A Case Report Publisher



Jabalameli M¹ ; Rahbar M¹ ; Karimi Haris H¹ ; Karimi A¹ ; Jokar R² ; Ghaderi MT¹ ; Fanaeian MM³ ; Mohammadpour M¹ Show Affiliations
Source: Current Orthopaedic Practice Published:2022

Abstract

Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a predominantly respiratory illness with associated symptoms such as dry cough, dyspnea, and hypoxemia. However, activation of the immune system after COVID-19 infection creates a hyperinflammatory state with multiorgan involvement.1 Musculoskeletal symptoms are among the most common nonrespiratory manifestations of COVID-19 and mainly present as fatigue, arthralgia, and myalgia.2 Reactive arthritis is one of the rare musculoskeletal manifestations of COVID- 19. To date, nearly 22 patients with COVID-19-associated reactive arthritis have been reported.3,4 The exact etiology of reactive arthritis in COVID-19 patients is unclear. The complex interaction between triggering environmental factors (infectious agents) and the host immune system in a genetically susceptible patient could result in activated autoimmunity, as presented by the cytokine storm in COVID-19. Reactive arthritis is also an autoimmune condition and could be the result of this interaction in COVID-19 setting.3,4 This study presents a 28-year-old male patient with a positive COVID-19 polymerase chain reaction (PCR) test who had reactive arthritis in the knee joint and was primarily misdiagnosed with septic arthritis. Informed consent was obtained from the participant who was included in this study. This study was exempt from institutional board of review approval per the institutional guidelines. © 2022 Lippincott Williams and Wilkins. All rights reserved.