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Bacteriuria in rheumatoid arthritis.

Pyelonephritis has been noted commonly in patients dying with rheumatoid arthritis (Clausen and Pedersen, 1961; Duthie, Brown, Truelove, Baragar, and Lawrie, 1964). Thus 47 5 per cent. of the patients reported by Lawson and McLean (1966) showed pathological features consistent with this diagnosis. Although not all patients with chronic pyelonephritis are thought to excrete micro-organisms persistently, one would expect that, with an incidence of pyelonephritis at post mortem which is so much higher than in the general population, the prevalence of bacteriuria in rheumatoid arthritics would exceed the expected figure of 4 to 6 per cent. (Kass, 1956). Moreover, rheumatoid arthritic subjects have been reported to have an abnormal susceptibility to systemic and particularly pulmonary infections (Cobb, Anderson, and Bauer, 1953; Walker, 1967), and this susceptibility might well be enhanced by treatment with steroid hormones. The present study compares the incidence of bacteriuria in a group of patients with rheumatoid arthritis with the incidence in a control group with particular reference to drug therapy.