Multiple infectious arthritis in ankylosing spondylitis: case report
Glazunov P.A., Zhilyaev E.V.

European Medical Center, Moscow

In patients with the fever of unknown origin associated with articular syndrome, differential diagnosis between infectious and inflammatory disorders is challenging for a practitioner. The combination of two independent conditions makes correct diagnosis even more difficult. 
This paper reports on a woman with multiple infectious arthritis and primarily diagnosed ankylosing spondylitis. The patient presented with complaints of right knee swelling and pain, high body temperature (38.5°C), severe thoracic and low back pain, diarrhea, and general weakness. Differential diagnosis included exacerbation of chronic urinary infection, cancer, multiple infectious arthritis, and exacerbation of spondyloarthritis due to the prior infection. Antibacterial agents, nonsteroidal anti-inflammatory drugs, and glucocorticoids were prescribed to achieve stable clinical effect. Considering the lack of further improvement, tumor necrosis factor α inhibitor was prescribed when infectious process was under control.
This case report illustrates complex relations between infection and autoimmune inflammation and successful resolution of this situation.

Key words: fever of unknown origin, articular syndrome, ankylosing spondylitis.
For citation: Glazunov P.A., Zhilyaev E.V. Multiple infectious arthritis in ankylosing spondylitis: case report // RMJ. 2017. № 7. P. 481–484.