Urethro-oculo-articular syndrome or urethritis-conjunctivitis-artheritis syndrome|
Reiter's syndrome describes a condition in
which there is inflammation of the urethra (a tube
carrying urine from the bladder to the outside), conjunctivum
(lining covering the eye), and joints (i.e., arthritis). Other
structures including the skin, nails, mouth, tongue, cervix,
prostate, bladder, penis, heart, and nervous system may also
- Among children, usually the disease occurs after 8 years of age.
- Occur 1- 2 weeks after the exposure
- Burning or stinging upon urination
- Discharge from the penis
- Painful ejaculation
- Urinary frequency
- Red, painful (burning) eye
- Discharge from the eye
- Dry eye
- May involve both eyes.
- Joint pains -- ankle, knees, lower
- Heel pain
- Pain over the tendons especially
behind the leg (Achilles tendon)
- Skin thickened (or inflammation)
around the nails or on the palms and soles
- Sores (painless and small) inside
the mouth, on the tongue, or on the head of the penis
- Fever, chills, heart problems (valve damage, inflammation of sac covering the heart, etc.) or damage to nerves, such as peripheral neuropathy (numbness, tingling, etc.), can also occur.
Follows an infection with Chlamydia trachomatis (sexually transmitted disease) or after food poisoning from or exposure to Diarrhea containing such bacteria as Salmonella, Yersinia, Shigella, and Campylobacter (dysenteric form).
- History of exposure, allergies, medication, habits, foods, travel, family history, illnesses, etc.
- Medical exam will reveal mouth or skin lesions, urethritis, conjunctivitis, and arthritis.
- X-ray picture of the joints, back, and heels may be done.
- Blood test will show increase in white blood cells, sedimentation rate, (indicates inflammation), and antibodies (protective proteins) to Chlamydia
- Test for HLA-B27
- If a joint is swollen, it may be tapped (using a needle) and the fluid sent for laboratory studies to rule out other causes of arthritis.
- Normally no bacteria are found in the joint fluid.
- Stool and urine samples may be sent for culture testing to see if bacteria are present
- Males > females
- Under 40 in sexually active individuals
- Other sexually-transmitted diseases
- HLA-B27 antigen -- individuals with this surface protein may be at higher risk.
- Symptomatic management
- NSAIDs (anti-inflammatories) such
as naproxen or indomethacin for joint pain and other
- Antibiotics if bacteria are found
- Corticosteroids are potent
anti-inflammatory agents that can be taken orally, used in
eye drops, lotions, or injected into the joints.
- Most cases resolve in 3-4 months
- In up to 50%, the course becomes
chronic, with relapse of some or all the symptoms.
- More potent anti-inflammatory drugs
(e.g., Methotrexate, Azathioprine) are being tested and used
in some cases (not recommended in HIV + individuals) as
- Physical therapy may be required after the illness to help injured joints recover.
Contact your pediatrician and have your child tested for Chlamydia or bacterial infection.