RT Book, Section
A1 Madoff, Lawrence C.
A2 Jameson, J. Larry
A2 Fauci, Anthony S.
A2 Kasper, Dennis L.
A2 Hauser, Stephen L.
A2 Longo, Dan L.
A2 Loscalzo, Joseph
SR Print(0)
ID 1177742378
T1 Viral Arthritis
T2 Harrison's Principles of Internal Medicine, 20e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259644016
LK accessmedicine.mhmedical.com/content.aspx?aid=1177742378
RD 2024/04/16
AB Viruses  produce  arthritis  by  infecting  synovial  tissue  during  systemic  infection  or  by  provoking  an  immunologic  reaction  that  involves  joints.  As  many  as  50%  of  women  report  persistent  arthralgias  and  10%  report  frank  arthritis  within  3  days  of  the  rash  that  follows  natural  infection  with  rubella  virus  and  within  2–6  weeks  after  receipt  of  live-virus  vaccine.  Episodes  of  symmetric  inflammation  of  fingers,  wrists,  and  knees  uncommonly  recur  for  >1  year,  but  a  syndrome  of  chronic  fatigue,  low-grade  fever,  headaches,  and  myalgias  can  persist  for  months  or  years.  IV  immunoglobulin  has  been  helpful  in  selected  cases.  Self-limited  monarticular  or  migratory  polyarthritis  may  develop  within  2  weeks  of  the  parotitis  of  mumps;  this  sequela  is  more  common  among  men  than  among  women.  Approximately  10%  of  children  and  60%  of  women  develop  arthritis  after  infection  with  parvovirus  B19.  In  adults,  arthropathy  sometimes  occurs  without  fever  or  rash.  Pain  and  stiffness,  with  less  prominent  swelling  (primarily  of  the  hands  but  also  of  the  knees,  wrists,  and  ankles),  usually  resolve  within  weeks,  although  a  small  proportion  of  patients  develop  chronic  arthropathy.