Reactive Arthritis Following Clostridium difficile Colitis in a 3-Year-Old Patient.

Reactive arthritis following antibiotic-associated Clostridium difficile (CD) colitis is becoming increasingly recognized in adults; 20 cases have been reported in the medical literature. We describe a 3-year-old patient with reactive arthritis following CD colitis, the first such reported case in a pediatric patient. The clinical features of reactive arthritis following CD colitis appear similar to those of more frequently described pathogens. The arthritis usually occurs 1-2 weeks after the onset of diarrhea, with an asymmetric oligoarticular distribution typically involving large lower extremity joints; resolution occurs in weeks to months. Reactive arthritis in children probably occurs less commonly than in adults, has fewer mucocutaneous manifestations, and follows infections caused by gastrointestinal pathogens much more frequently than genitourinary organisms.