REITER'S SYNDROME

General Information

DEFINITION--An inflammatory disease characterized by a complex of symptoms resembling those of arthritis, urethritis, conjunctivitis and psoriasis.

BODY PARTS INVOLVED--Joints; eyes, including white eye covering; urethra and head of the penis; skin.

SEX OR AGE MOST AFFECTED--Male adolescents and young adults (12 to 40 years). This is rare in women and children.

SIGNS & SYMPTOMS

• Inflammation of the urethra and discharge within 7 to 14 days after sexual intercourse.
• Frequent urinary urgency.
• Small ulcers inside the mouth, tongue and on the penis tip.
• Low fever.
• Red eyes.
• Painful joints, especially toes, legs, hips and back.
• Aching in the pelvis.
• Skin lesions similar to psoriasis on the soles, palms and around fingernails and toenails.

CAUSES--Unknown. The predisposition is inherited, and two forms are recognized: Sexually transmitted (Chlamydia infection most often implicated) and dysenteric (follows a gastrointestinal bacterial infection).

RISK INCREASES WITH

• Recent gastrointestinal illness with diarrhea.
• Previous sexually-transmitted infections.
• Family history of Reiter's syndrome.
• Genetic factors.

HOW TO PREVENT--Use condoms for sexual intercourse.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies and culture of the urethral discharge and x-rays.

APPROPRIATE HEALTH CARE

• Doctor's treatment for diagnosis and supervision of treatment.
• There is no treatment to cure Reiter's. Symptoms are usually managed with medication.
• Treatment for sexually transmitted disease with antibiotics for patients and their sexual partners. Patients with guilt or anxiety feelings about sexually transmitted disease should seek counseling or psychological help.
• Usually, no treatment is needed for eye symptoms, unless severe or chronic.

POSSIBLE COMPLICATIONS--Stiffening and effusion (fluid) of joints.

PROBABLE OUTCOME--Arthritis symptoms may continue up to 4 months, others disappear sooner. Most patients recover in 2 to 16 weeks with no residual signs of the disease, but some persons have recurrent flare-ups and remissions.

How To Treat

GENERAL MEASURES--

• To relieve foot pain, wear cushion pads and arch supports in your shoes.
• Use a firm mattress on your bed.
• If joint impairment is chronic, ask your doctor about occupational therapy.

MEDICATION--Your doctor may prescribe:

• Nonsteroidal anti-inflammatory drugs.
• Antibiotics, such as tetracyclines, for urethritis.

ACTIVITY--

• Stay as active as your condition allows, but avoid sexual excitement and activity during the illness.
• Exercise the affected joints according to instructions from your doctor or physical therapist. Don't immobilize affected joints.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of Reiter's syndrome.
• Symptoms recur after recovery.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.