Update on rheumatic manifestations of infectious diseases.

PURPOSE OF REVIEW: As infectious diseases continue to emerge, and as molecular techniques advance, the rheumatic manifestations of infectious diseases are increasingly recognized and better understood. Herein, we review important recent clinical, epidemiologic, and basic science advances within this area of rheumatology.

RECENT FINDINGS: We searched the U.S. National Library of Medicine PubMed database for relevant articles published since 1 January 2008. We identified a number of studies suggesting a potentially greater role for persistent viral and bacterial infections in the development of rheumatoid arthritis or rheumatoid arthritis-like syndromes. These include emerging pathogens like Chikungunya virus, as well as historically important pathogens like measles. New literature furthers the idea that antecedent infections with Chlamydia sp. could be causative in some cases of undifferentiated spondyloarthritis. Other studies document diagnostic methods capable of distinguishing between Hepatitis C virus and auto-immune driven arthritis allowing clinicians to better target therapy.

SUMMARY: Infectious pathogens are increasingly recognized in association with rheumatic disease. Rheumatologists should be aware of this trend as such recognition may alter the diagnosis and management of rheumatic symptoms, as well as trigger new research opportunities to better understand the causes of rheumatic disease.