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Reiter's Syndrome

more about Reiter's Syndrome

Urethro-oculo-articular syndrome or urithritis-conjunctivitis-arthritis syndrome

  • Reiter's syndrome describes a condition in which there is inflammation (i.e., itis) --  irritation, swelling, damage -- to the urethra (a tube carrying urine from the bladder to the outside); conjunctiva (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 be affected.

  • 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 back, etc.  The sacroiliac joint (joint between the tail bone and pelvis in the buttocks) is classically affected.
  • Heal 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 (glans) 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 (classically sacroiliitis is present).
  • Tests:
    1. X-Ray picture of the joints, back, and heals may be done.
    2. Blood test will show increase in white blood cells, ESR (indicates inflammation), and antibodies (protective Proteins) to Chlamydia
    3. Test for HLA-B27
    4. 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.
    5. Normally no bacteria are found in the joint fluid.
    6. Stool and urine samples may be sent for testing to see if bacteria are present (using a culture) help in arriving at diagnosis.

  • 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 inflammatory conditions
  • 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 possible therapies-physical therapy may be required after the illness to help injured joints recover.

  • Contact your physician and avoid sexual intercourse until you have been tested for Chlamydia.

more about Reiter's Syndrome

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