When the Infection Clears but Inflammation Persists: A Case of Chlamydia-Associated Reactive Arthritis Requiring Disease-Modifying Antirheumatic Drug (DMARD) Therapy
Year: 2026
Type: article
Study design: Case Report
Abstract: Reactive arthritis (ReA) can be a persistent and debilitating form of arthritis that is a consequence of a gastrointestinal or genitourinary infection. Although most cases self-resolve, a small subset of cases may persist and require an escalation of care to manage their symptoms. We present a case of recurrent ReA induced by Chlamydia trachomatis infection in a young male patient who required a stepwise escalation of his medical management. This case outlines a 32-year-old man followed over six months from his diagnosis. Initially, the patient presented with persistent joint pain in the lower extremities, elevated inflammatory markers, a positive HLA-B27 antigen, and a positive Chlamydia test. He was treated for his initial symptomatology with antibiotics and systemic steroids, and later, methotrexate was added, with clinical improvement. However, several months later, the patient relapsed and required the initiation of a biologic disease-modifying antirheumatic drug (DMARD). This case is an opportunity to follow a case of C. trachomatis-induced ReA, and through a literature review, it details the considerations clinicians must take into account to manage their patients’ symptomatology.
Source: Cureus
Institutions: Saint Michael's Medical Center, Jersey City Medical Center
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7125020859