{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T08:07:26Z","timestamp":1784966846181,"version":"3.55.0"},"reference-count":9,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,3,5]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>A 20-year-old Caucasian man with a history of psoriasis presented to the emergency department due to a 2-week history of severe polyarthralgia and a 3-week history of non-bloody diarrhoea. The initial workup 2\u2009days prior in an urgent care clinic returned negative for all enteric pathogens including <jats:italic>Clostridioides difficile<\/jats:italic> nucleic acid amplification test. Investigations revealed colitis on CT and pseudomembranous colitis on colonoscopy. The aspirate returned positive for <jats:italic>C. difficile<\/jats:italic> toxin. Tissue biopsies of the ascending, transverse, sigmoid colon and rectum were negative for chronicity to suggest inflammatory bowel disease with extraintestinal manifestation as the aetiology of polyarthralgia, which had been the most likely differential diagnosis until that point. The biopsy confirmed the diagnosis of reactive arthritis in the setting of <jats:italic>C. difficile<\/jats:italic> colitis. The patient improved on treatment with naproxen and was referred to rheumatology where he was found to be HLA-B27 positive.<\/jats:p>","DOI":"10.1136\/bcr-2020-240890","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T13:22:37Z","timestamp":1617283357000},"page":"e240890","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Reactive arthritis: an unusual presentation of acute <i>Clostridioides difficile<\/i> colitis"],"prefix":"10.1136","volume":"14","author":[{"given":"Anna","family":"Reinholz","sequence":"first","affiliation":[{"name":"Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devendranath","family":"Mannuru","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA"},{"name":"Internal Medicine, Sanford Medical Center, Fargo, North Dakota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinesh","family":"Bande","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA"},{"name":"Internal Medicine, Sanford Medical Center, Fargo, North Dakota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhisnek","family":"Matta","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA"},{"name":"Internal Medicine, Sanford Medical Center, Fargo, North Dakota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"key":"2025082623563521000_14.4.e240890.1","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.anaerobe.2015.12.011","article-title":"Clostridium difficile associated reactive arthritis: case report and literature review","volume":"38","author":"Legendre","year":"2016","journal-title":"Anaerobe"},{"key":"2025082623563521000_14.4.e240890.2","doi-asserted-by":"publisher","DOI":"10.1097\/01.meg.0000131040.38607.09"},{"key":"2025082623563521000_14.4.e240890.3","first-page":"2185","article-title":"On the difficulties of establishing a consensus on the definition of and diagnostic investigations for reactive arthritis. results and discussion of a questionnaire prepared for the 4th International workshop on reactive arthritis, Berlin, Germany, July 3-6, 1999","volume":"27","author":"Braun","year":"2000","journal-title":"J Rheumatol"},{"key":"2025082623563521000_14.4.e240890.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2011.01.018"},{"key":"2025082623563521000_14.4.e240890.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2009.03.010"},{"key":"2025082623563521000_14.4.e240890.6","article-title":"Clostridium difficile Colitis Leading to Reactive Arthritis: A Rare Complication Associated With a Common Disease","volume":"6","author":"Marwat","year":"2018","journal-title":"J Investig Med High Impact Case Rep"},{"key":"2025082623563521000_14.4.e240890.7","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1111\/jdv.12741","article-title":"Reactive arthritis","volume":"29","author":"Stavropoulos","year":"2015","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2025082623563521000_14.4.e240890.8","doi-asserted-by":"crossref","DOI":"10.3402\/jchimp.v6.30151","article-title":"A case of reactive arthritis due to Clostridium difficile colitis","volume":"6","author":"Essenmacher","year":"2016","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"2025082623563521000_14.4.e240890.9","article-title":"Clostridium difficile enterocolitis and reactive arthritis: a case report and review of the literature","volume":"2016","author":"Cappella","year":"2016","journal-title":"Case Rep Pediatr"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240890","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:56:45Z","timestamp":1756277805000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240890"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":9,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,1]]},"published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1136\/bcr-2020-240890"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240890","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}