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C Deighton

Publications and source records attributed to C Deighton.

22 records · Page 2Linked to original sources
PubMed1993

Beta haemolytic streptococci and reactive arthritis in adults.

There is an increasing occurrence of reactive group A beta haemolytic streptococci (BHS) phenomena. This review makes a case for considering BHS in the differential diagnosis of adult reactive arthritis. This is based on (a) published reports over the past 45 years describing first attacks of rheumatic fever in adults; (b) the longstanding observation that polyarthritis is the most commonly expressed Jones major criterion in adults; (c) the broad spectrum of clinical expression of disease following streptococcal infection, with the re-emergence of the term 'poststreptococcal reactive arthritis'. The arthritis in adult rheumatic fever is characterised by sequential involvement of large weightbearing joints. Recurrent, severe, prolonged arthritis has been a prominent feature of adult poststreptococcal reactive arthritis. Carditis has been reported in 33% of adult patients with rheumatic fever. Consequently long term antibiotic prophylaxis for adults with reactive BHS phenomena should be strongly considered, and guidelines are suggested for this in individual patients. Further areas for research are discussed, particularly the interrelations between bacteria and host in disease expression, and the possibility that BHS might play a part in chronic arthritides and vasculitides.

Adult↗
PubMed1993

Beta haemolytic streptococci and musculoskeletal sepsis in adults.

Lancefield group A streptococci (GAS) account for 3-17% cases of septic arthritis, but other beta haemolytic streptococci (BHS) (groups B, C, and G) are being increasingly implicated. Epidemiological evidence suggests that the increase of BHS sepsis in adults is a true increase and not simply a reflection of better reporting. While underlying predisposing disease and old age are common concomitants of BHS sepsis, some subjects with devastating disease have been young and healthy. This is particularly the case for highly virulent M1 serotypes of GAS, where a toxic shock-like syndrome has led to a number of deaths in young adults in the United Kingdom and elsewhere. Musculoskeletal features, such as myalgias, painful swollen limbs, myositis, and fasciitis, are important features of this condition, so that rheumatologists may be involved in management. Group C and G musculoskeletal sepsis remains uncommon, with a high prevalence of underlying predisposing disease, or pre-existing arthritis in the septic joint. Group B BHS septic disease appears to be increasing in incidence. Musculoskeletal sepsis with these organisms usually takes place in subjects with other diseases, but healthy subjects have not been spared. Multiple septic foci and a rapidly destructive arthritis are not uncommon, and a recently described extra-articular feature is potentially blinding metastatic endophthalmitis. Clinicians need to be aware of an apparently increasing incidence of BHS musculoskeletal sepsis in adults so that early identification can lead to aggressive management in these potentially fatal infections.

Adult↗