{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:16:58Z","timestamp":1790921818661,"version":"4.1.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T00:00:00Z","timestamp":1600300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T00:00:00Z","timestamp":1600300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>We report a case of a 30-year-old patient who presented with acute <jats:italic>Mycoplasma pneumoniae<\/jats:italic> infection that was complicated by reactive arthritis and asymmetric proximal myopathy and progressed to chronic spondyloarthropathy. Reactive arthritis and sacroiliitis are unusual extrapulmonary manifestations of <jats:italic>M. pneumoniae<\/jats:italic> infection, which is a common condition.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 30-year-old Greek previously healthy man presented to our emergency department with fever, progressively worsening bilateral lower limb weakness, and asymmetric oligoarthritis. Our diagnosis was based on a positive polymerase chain reaction test for <jats:italic>M. pneumoniae<\/jats:italic> using blood and cerebrospinal fluid and magnetic resonance imaging findings that suggested sacroiliitis. Our patient was also found to be human leukocyte antigen B27 positive. His infection was successfully treated with a 14-day course of doxycycline; the arthritis was treated with naproxen and corticosteroids. His arthritis, which restricted his mobility, improved progressively, and he was discharged without any neurological symptoms.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In our case, an acute <jats:italic>M. pneumoniae<\/jats:italic> infection eventually progressed to chronic spondyloarthropathy. In our patient, <jats:italic>M. pneumoniae<\/jats:italic> infection may represent a random event, or it might be a necessary factor for the development of reactive arthritis, asymmetric proximal myopathy, and sacroiliitis, always in combination with the appropriate genetic background. Extrapulmonary manifestations of <jats:italic>M. pneumoniae<\/jats:italic> may occur even in the complete absence of respiratory symptoms, and the diagnosis of unusual complications, such as reactive arthritis, requires high clinical suspicion and extensive investigation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-020-02479-6","type":"journal-article","created":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T23:05:28Z","timestamp":1600297528000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Chronic seronegative spondyloarthropathy following acute Mycoplasma pneumoniae infection in a human leukocyte antigen B27-positive patient: a case report"],"prefix":"10.1186","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4170-2573","authenticated-orcid":false,"given":"Georgios","family":"Pilianidis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariti","family":"Tsinari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Pandis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hara","family":"Tsolakidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Petridis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,17]]},"reference":[{"key":"2479_CR1","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1093\/rheumatology\/keh630","volume":"44","author":"AS Ramirez","year":"2005","unstructured":"Ramirez AS, Rosas A, Hernandez-Beriain JA. Relationship between rheumatoid arthritis and Mycoplasma pneumoniae: a case\u2013control study. Rheumatology. 2005;44:912\u20134..","journal-title":"Rheumatology"},{"issue":"2","key":"2479_CR2","first-page":"113","volume":"12","author":"A Timitilli","year":"2004","unstructured":"Timitilli A, Di Rocco M, Nattero G. Unusual manifestations of infections due to Mycoplasma pneumoniae in children. Infez Med. 2004;12(2):113\u20137.","journal-title":"Infez Med"},{"issue":"4","key":"2479_CR3","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1007\/s10067-005-0085-1","volume":"25","author":"M Harjacek","year":"2006","unstructured":"Harjacek M, Ostojic J, Djakovic Rode O. Juvenile spondyloarthropathies associated with Mycoplasma pneumoniae infection. 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A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"No competing interests were disclosed.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"155"}}