What is the most likely cause of symptoms in a patient with acute inflammation of multiple joints after starting allopurinol?

In this scenario, the symptoms of acute inflammation of multiple joints occurring after the initiation of allopurinol therapy suggest an underlying issue linked to the recent medication change. Allopurinol is primarily used to reduce uric acid levels and prevent gout attacks. However, it can also be associated with acute inflammatory responses in susceptible patients.

One key reason for selecting joint sepsis as the most likely cause is that allopurinol may have altered the patient's uric acid levels, potentially leading to a cutoff of protective mechanisms against infection in the joints. Joint sepsis is characterized by signs of inflammation and can occur in multiple joints, particularly if an individual has other risk factors predisposing them to infections. In addition, the onset of joint inflammation shortly after the initiation of allopurinol hints at an acute process where septic arthritis could be precipitated by the metabolic changes induced by the medication.

Acute pseudogout could potentially present similarly with polyarthritis, particularly with calcium pyrophosphate crystal deposition, but this condition typically arises independently of the initiation of allopurinol. An alcoholic binge could lead to inflammatory arthritis flares, but it doesn't have the direct link to the recent medication change like joint sepsis does. An allergic reaction to allopurin