Reiter’s Syndrome is a type of reactive arthritis that happens as a reaction to a bacterial infection in the body.
It is characterized by urethritis (hurts to pee!). Urethritis is inflammation of the urethra with the more common symptom being painful or difficult urination.
Conjunctivitis is another characteristic of Reiter’s Syndrome (can’t see!). This is inflammation of the outer membrane of the eyeball and the inner eyelid. The eye is not infected, however the immune system is acting as if the eye is infected.
The third characteristic of Reiter’s Syndrome is joint arthritis or reactive arthritis (can’t climb a tree!). This is asymmetrical. The knees and the joints of the ankles and feet are the usual targets of reactive arthritis. The fluid culture is negative for infection.
Infection enters the body and triggers the immune system. The job of the immune system is to get rid of the infections. The immune system creates antibodies. These antibodies attack the infection. The antibodies then cross over and attack the normal body cells. This is why they call it reactive arthritis. It reacts to the infection that the body already went through. It usually is associated with infection after the initial infection is gone (residual immune effect).
What are the infections associated with Reiter’s Syndrome?
The infections associated with Reiter’s Syndrome can be either a GI infection of GU infection. GI infections include salmonella and shigella. GU infections include gonorrhea and chlamydia, these normally occur in young men.
Some people are more susceptible to get Reiter’s Syndrome than others. Most cases resolve within weeks but may last longer. There is a recurrence in about 50% of patients. Reiter’s Syndrome usually starts 1-3 weeks after the original infection (up to 45 days). The patient is seronegative spondyloarthropathy, which is in the same family of disorders as ankylosing spondylitis and psoriatic arthritis. 70% of patients are positive for HLA-B27.
Remember that in test examinations, they may test on Achilles tendon pain (Achilles tendonitis) with heel pain (plantar fasciitis) and its association with Reiter’s Syndrome. Also remember that Cipro (antibiotic used to treat bacterial infections) can cause a rupture of the Achilles tendon.
Symptomatic treatment it utilized for Reiter’s Syndrome. The patient will also be observes and antibiotics will be administered for the underlying infection. Steroids may be given for severe cases. Reiter’s Syndrome is not gonococcal urethritis.
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