{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:58:57Z","timestamp":1791219537638,"version":"4.1.0"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,7,2]]},"abstract":"<jats:p>A 35-year-old man presented with polyarthritis and constitutional symptoms, and a recent history of multiple tick bites and skin rash on trekking holiday. He did not respond to oral doxycycline and cephalexine for presumed Lyme's disease. Further investigation confirmed strongly positive streptococcal serology. There was absence of clinical or echocardiography evidence of heart involvement and immunological screening for inflammatory arthritis was negative. In the absence of other major Jones criteria for acute rheumatic fever, besides polyarthritis and the serological evidence of a recent streptococcal infection, a diagnosis of post-streptococcal reactive arthritis (PSRA) was also made. He responded well to penicillin therapy and has been started on oral penicillin prophylaxis as per available guidance. As streptococcal infections in the adult population are increasingly reported, it is a timely opportunity to revisit PSRA, and develop comprehensive treatment and antibiotic prophylaxis guidelines.<\/jats:p>","DOI":"10.1136\/bcr-2016-215552","type":"journal-article","created":{"date-parts":[[2016,8,12]],"date-time":"2016-08-12T08:02:48Z","timestamp":1470988968000},"page":"bcr2016215552","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Post-streptococcal reactive arthritis: where are we now"],"prefix":"10.1136","volume":"2016","author":[{"given":"Himanshu","family":"Pathak","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarnya","family":"Marshall","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,8,12]]},"reference":[{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.1","unstructured":"Health Protection report. Group A streptococcal infections: sixth update on seasonal activity, 2014\/15. Public Health England, 2015. Infection report Volume 9 Number 23."},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.2","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1542\/peds.23.5.879","article-title":"The nature of scarlatinal arthritis","volume":"23","author":"Crea","year":"1959","journal-title":"Pediatrics"},{"issue":"4","key":"2025082803281747000_2016.aug12_1.bcr2016215552.3","first-page":"S18","article-title":"Streptococcal disease of childhood\u2013a changing syndrome","volume":"25","author":"Goldsmith","year":"1982","journal-title":"Arthritis Rheum"},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.4","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh225"},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.5","first-page":"90","article-title":"Update on complications of group A streptococcal infections","volume":"27","author":"Ayoub","year":"1997","journal-title":"Curr Probl Pediatr"},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.6","doi-asserted-by":"publisher","DOI":"10.1097\/00002281-200209000-00014"},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.7","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e328337ba26"},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.8","doi-asserted-by":"publisher","DOI":"10.1186\/1546-0096-9-32"},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.9","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.1999.0438e.x"},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.10","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199806)41:6<1096::AID-ART17>3.0.CO;2-Y"},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.11","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-006-0296-z"},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.12","doi-asserted-by":"publisher","DOI":"10.1002\/art.24401"},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(11)64185-2"},{"key":"2025082803281747000_2016.aug12_1.bcr2016215552.14","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.191959"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-215552","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:28:26Z","timestamp":1756376906000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-215552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,12]]},"references-count":14,"alternative-id":["10.1136\/bcr-2016-215552"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-215552","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8,12]]}}}