Because the standard constellation of symptoms in Reiter syndrome (arthritis, conjunctivitis, and urethritis) is not typically present in all patients, the disease can be easily overlooked if clinical suspicion is not high upon presentation. [ncbi.nlm.nih.gov]

• Asymptomatic

  The LGV-associated arthritis has to be considered even when classic symptoms of arthritis are missing and in case of asymptomatic or cryptic LGV localizations. [ncbi.nlm.nih.gov]

• Constitutional Symptom

  A 35-year-old man presented with polyarthritis and constitutional symptoms, and a recent history of multiple tick bites and skin rash on trekking holiday. He did not respond to oral doxycycline and cephalexine for presumed Lyme's disease. [ncbi.nlm.nih.gov]

  Symptoms and Signs of Reactive Arthritis Reactive arthritis can range from transient monarticular arthritis to a severe, multisystem disorder. Constitutional symptoms may include fever, fatigue, and weight loss. Arthritis may be mild or severe. [merckmanuals.com]

  These tissue-specific symptoms are often accompanied by constitutional symptoms such as fever and fatigue. [pathwaymedicine.org]

  […] and urethritis, see posts Constitutional symptoms are very common- e.g. fatigue, mild fever, muscle aches Musculoskeletal symptoms Typically lower limb, asymmetrical oligoarthritis with a relatively acute onset (swollen, hot, painful, tender, red joints [dundeemedstudentnotes.wordpress.com]

• Heart Failure

  Rheumatic heart disease is a serious complication with high morbidity and mortality. Treatment of ARF is with prolonged antibiotics and management of organ involvement such as heart failure from carditis or valvular disease. [pmmonline.org]

  It can lead to failure of the aortic valve of the heart, which can cause heart failure. [medicinenet.com]

• Oral Ulcers

  On examination, Behcet-mimicking symptoms were observed, such as genital and oral ulcers and arthritis. Furthermore, S. viridans was found in the urethral discharge culture. [ncbi.nlm.nih.gov]

  Some examples include eye inflammation, discharge from your penis or vagina, skin rashes or lesions, oral ulcers, joint inflammation and heel pain. [sparshhospital.com]

  ulcers Dermatologic manifestations ; : skin lesions of the glans resembling psoriasis ( balanitis circinata ; ); hyperkeratinization of the palms and soles ( keratoderma blenorrhagicum ) Symptoms from preceding infection Diarrhea Urogenital tract symptoms [amboss.com]

  These include: Genitourinary tract symptoms, such as dysuria and pelvic pain, conjunctivitis and, less frequently, anterior uveitis, oral ulcers, rashes such as keratoderma blennorrhagica (hyperkeratotic skin lesions on soles and palms), nail changes [eldersarthritis.com]

  Medications for Treating Eye Symptoms in ReA If a skin rash or oral ulcers are present, a topical (applied to the surface) steroid such as cortisone is used. Eye drops that contain cortisone are usually used to treat conjunctivitis. [rheuminfo.com]

• Ulcer

  On examination, Behcet-mimicking symptoms were observed, such as genital and oral ulcers and arthritis. Furthermore, S. viridans was found in the urethral discharge culture. [ncbi.nlm.nih.gov]

  In some men, small, shallow, painless ulcers may form on the penis; this is referred to as circinate balanitis. These ulcers may precede the development of arthritis. Occasionally these ulcers can form a plaque-like lesion and become chronic. [rarediseases.org]

  However, taking a regular dose of a NSAID on a long-term basis can increase your risk of problems such as stomach ulcers. [nhsinform.scot]

  Mucocutaneous lesions—small, transient, relatively painless, superficial ulcers—commonly occur on the oral mucosa, tongue, and glans penis (balanitis circinata). [merckmanuals.com]

• Skin Lesion

  Psoriatic arthritis can simulate reactive arthritis, causing similar skin lesions, uveitis, and asymmetric arthritis. [merckmanuals.com]

  Presenting features include systemic symptoms such as fever, peripheral and axial arthritis, enthesitis (inflammation where tendons insert into bone), dactylitis (swelling of an entire finger or toe), conjunctivitis and iritis, and skin lesions including [bestpractice.bmj.com]

  Gonococcal Arthritis - may present with fever, rigors, skin lesions (macular rash, pustules, or blisters), tenosynovitis, and polyarthritis. The sexual history needs to be explored but the possibility of sexual abuse should be considered. [pmmonline.org]

  Topical corticosteroids : Corticosteroid creams or lotions can be applied to skin lesions. [sparshhospital.com]

• Blister

  Gonococcal Arthritis - may present with fever, rigors, skin lesions (macular rash, pustules, or blisters), tenosynovitis, and polyarthritis. The sexual history needs to be explored but the possibility of sexual abuse should be considered. [pmmonline.org]

  They often begin as clear vesicles (blisters) on a red base and progress to macules (flat lesions), papules (raised lesions), and nodules (firm bumps). [13] In addition, some people develop mouth ulcers that come and go. [about-reactive-arthritis.com]

  The skin of the palms of the hands and/or the soles of the feet can develop tiny fluid-filled blisters that sometimes are filled with old blood. The affected skin can peel and may mimic psoriasis. [medicinenet.com]

• Keratosis Blennorrhagica

  Skin rashes on the soles of the feet and, less often, on the palms of the hands or elsewhere may also occur; these rashes are called keratoderma blennorrhagicum (or keratosis blennorrhagica) and are similar to psoriasis. [about-reactive-arthritis.com]

• Anterior Uveitis

  It usually causes mild eye redness and grittiness, but keratitis and anterior uveitis can develop also, causing eye pain, photophobia, and tearing. [merckmanuals.com]

  Ocular inflammation may amount to a simple conjunctivitis or an aggressive anterior uveitis. These tissue-specific symptoms are often accompanied by constitutional symptoms such as fever and fatigue. [pathwaymedicine.org]

  Antibiotic treatment is indicated for cervicitis or urethritis but generally not for post-dysenteric ReA Mydriatics and cycloplegics (eg, atropine) with topical corticosteroids may be administered in patients with acute anterior uveitis. [boneandspine.com]

  In these individuals, consider: Sulfasalazine Methotrexate Anterior uveitis – may be treated with steroid eye drops Related Articles Tags: Rheumatology Sexual Health Dr Tom Leach MBChB DCH EMCert(ACEM) currently works as a GP Registrar and an Emergency [almostadoctor.co.uk]

• Eye Pain

  It is characterized by inflammation of the joints, tendons, urogenital tract, and eyes. Pain and swelling in the knees, ankles, and feet are common. [clinicaltrials.gov]

  Symptoms can include: red eyes watery eyes eye pain swollen eyelids sensitivity to light See an eye specialist or go to A & E as soon as possible if one of your eyes becomes very painful and the vision becomes misty. [nhsdirect.wales.nhs.uk]

  In some people it can also affect the: genital tract – causing pain when peeing, or discharge from the penis or vagina eyes – causing eye pain, redness, sticky discharge, conjunctivitis and, rarely, inflammation of the eye (iritis) See an eye specialist [nhs.uk]

  Other symptoms of reactive arthritis can include low-grade fever, malaise, low back pain, erythema, photophobia, eye pain, conjunctivitis, uveitis, tendinitis, tenosynovitis, urethritis, mouth ulcers and skin rashes. [medicalmarijuana.com]

  Conjunctivitis and uveitis may cause redness and swelling of the eyes, eye pain, blurred vision, an abnormal sensitivity to light (photophobia) and crusting in the morning. Blurred vision and photophobia are more common with uveitis. [rarediseases.org]

• Photophobia

  A 9-year-old girl, with no past ocular history, presented with a 5-day history of bilateral blurred vision, red eyes, photophobia and walking difficulties because of a right ankle pain. [ncbi.nlm.nih.gov]

  Conjunctivitis and uveitis may cause redness and swelling of the eyes, eye pain, blurred vision, an abnormal sensitivity to light (photophobia) and crusting in the morning. Blurred vision and photophobia are more common with uveitis. [rarediseases.org]

  Ophthalmologic problems include conjunctivitis with erythema, burning, tearing, and photophobia. Iritis and uveitis are less common. [orpha.net]

  Acute anterior uveitis (iritis) can occur and is associated with severe ocular erythema, pain and photophobia. Articular manifestations typically appear last, often after symptoms of urethral and ocular inflammation have subsided. [pacificarthritis.com]

• Excessive Tearing

  The conjunctiva (the membrane that lines the eyelid and covers the eyeball) can become red and inflamed, causing itching or burning, sensitivity to light, and sometimes pain and excessive tearing. [merckmanuals.com]

• Arthritis

  How is reactive arthritis treated? The type of treatment for reactive arthritis depends on the stage of reactive arthritis. The early stage of reactive arthritis is considered acute (early). [rheumatology.org]

  Gonococcal arthritis. Gout. Inflammatory bowel disease. Psoriatic arthritis. Rheumatic fever. Rheumatoid arthritis. Septic arthritis. [patient.info]

  Once arthritis is observed, however, microbial tests and blood or synovial fluid cultures are negative, and only serum antibodies are detected. Reactive arthritis commonly affects young adults, most frequently white and carrying the HLA-B27 allele. [ncbi.nlm.nih.gov]

• Oligoarthritis

  Reactive arthritis usually presents as a sterile, inflammatory, asymmetric oligoarthritis, affecting large lower extremity joints. [ncbi.nlm.nih.gov]

  An asymmetrical, predominantly lower extremity, oligoarthritis (usually no more than six joints) is the major presenting symptom. [ 6 ] Low back pain often occurs. [patient.info]

• Enthesopathy

  Enthesopathy (inflammation at tendinous insertion into bone—eg, plantar fasciitis, digital periostitis, Achilles tendinitis) is common and characteristic. [merckmanuals.com]

  Extra-articular features (conjunctivitis, uveitis, enthesopathy, urethritis, balanitis, keratoderma blenorrhagicum) may occur. [ncbi.nlm.nih.gov]

  A condition called enthesopathy also commonly occurs, in which the tendon that attaches to the bone becomes inflamed. [8, 13] Enthesopathies occur in 5 to 21% of individuals with Salmonella -associated arthritis. [8] The heel is the most common site with [about-reactive-arthritis.com]

• Arthralgia

  Staphylococcal septicemia, while frequently associated with arthralgia, has rarely been associated with a sterile arthritis, although it infrequently results in septic arthritis. [ncbi.nlm.nih.gov]

• Joint Swelling

  The symptoms of reactive arthritis include: Arthritis Joint swelling and pain Joint stiffness Joint redness Pain that is out of proportion to what is showing on an exam (for instance, there is only a little swelling but a lot of pain) Diagnosis of Reactive [rileychildrens.org]

  It can make your joints swell and hurt, similar to arthritis. Reactive arthritis may be called Reiter’s syndrome or Fiessinger-Leroy’s disease. [familydoctor.org]

  Reactive arthritis is a relatively short-lived condition causing painful joint swelling. It develops in response to and occurs shortly after an infection, usually of the bowel, genital tract or throat. [dundeemedstudentnotes.wordpress.com]

• Dysuria

  A previously healthy 48-year-old man presented with a 1-week history of migrating polyarthropathy preceded by a viral illness, dysuria and bilateral red eyes. Ocular examination revealed anterior and interstitial stromal keratitis. [ncbi.nlm.nih.gov]

  Mild dysuria and a purulent discharge are the most typical symptoms in men, but occasionally, prostatitis and/or epididymitis are present. Women may have dysuria, vaginal discharge and purulent cervicitis and/or vaginitis. [pacificarthritis.com]

  In women, urethritis and cervicitis may be mild (with dysuria or slight vaginal discharge) or asymptomatic. Conjunctivitis is the most common eye lesion. [merckmanuals.com]

  Dysuria or pelvic pain may be a manifestion of sterile urethritis (aseptic urethritis or culture negative urthritis) that may be a prominent and troublesome clinical feature. [eldersarthritis.com]

• Vaginal Discharge

  Mild dysuria and a purulent discharge are the most typical symptoms in men, but occasionally, prostatitis and/or epididymitis are present. Women may have dysuria, vaginal discharge and purulent cervicitis and/or vaginitis. [pacificarthritis.com]

  In women, the genital and urinary symptoms, if any occur, are usually mild, consisting of a slight vaginal discharge or uncomfortable urination. [merckmanuals.com]

Reactive Arthritis Workup. Available online at http://emedicine.medscape.com/article/331347-workup#c6. Accessed July 23, 2017. National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2016. [labtestsonline.org]

[…] infectious process, especially in monoarticular arthritis with constitutional symptoms) Antistreptolysin O (ASO) or anti-DNase B testing (if poststreptococcal infection is suspected) Electrocardiography (ECG; in patients with a prolonged course of ReA) See Workup [emedicine.com]

• Chlamydia Trachomatis

  KEYWORDS: Chlamydia pneumoniae; Chlamydia trachomatis; Chlamydia-induced arthritis; combination antibiotic therapy; persistent bacterial infection; reactive arthritis; spondyloarthritis [ncbi.nlm.nih.gov]

Complete resolution of ocular and systemic symptoms was achieved after 2 months of treatment. Streptococcus viridans is potential microorganisms of ReA. Careful survey and prompt treatment is necessary. [ncbi.nlm.nih.gov]

Antibiotic treatment does not change the course of reactive arthritis, even when an infective cause is identified. [patient.info]

The outcome and prognosis of ReA are best known for enteric ReA, whereas studies dealing with the long-term outcome of ReA attributable to Chlamydia trachomatis are lacking. Copyright © 2011 Elsevier Ltd. All rights reserved. [ncbi.nlm.nih.gov]

[…] risk factors for poor prognosis: nature of the infection, persistent infection with Chlamydia, the presence of HLA-B27 (axial involvement, ocular), male gender, recurrent arthritis and a family history of the disease Reference: Dumond DC. [gpnotebook.co.uk]

Prognosis Prognosis is variable. Two-thirds of patients develop prolonged joint discomfort, lower back pain or an enthesopathy after acute ReA. Severe chronic sequelae may develop in up to 30% of cases. [orpha.net]

The clinical syndrome of reactive arthritis can be easily remembered with the mnemonic: Can't see, can't pee, can't climb a tree Etiology and Pathogenesis Although the etiology of Reactive Arthritis is incompletely understood, it appears to be the result [pathwaymedicine.org]

Chlamydia trachomatis and Chlamydophila pneumoniae are human pathogens; the former being the etiologic agent for trachoma as well as a prevalent sexually transmitted bacterium, while C. pneumoniae is a respiratory pathogen responsible for community-acquired [ncbi.nlm.nih.gov]

Prospective epidemiologic data suggest that Chlamydia-induced reactive arthritis is underdiagnosed. [ncbi.nlm.nih.gov]

An invaluable tool for differential diagnosis of STDs, the atlas features one to two color photograph for each disorder and accompanies those with the salient points of epidemiology, clinical signs, physical exam, diagnosis, and management. [books.google.com]

The epidemiology is similar to other reactive arthritides, characterized by sterile joint inflammation associated with infections originating at nonarticular sites. [unboundmedicine.com]

We further discuss the context of pathophysiology of the arthritis in these patients, with an emphasis on the immunomodulatory properties of these two pathogens. [ncbi.nlm.nih.gov]

The pathophysiology of all the seronegative reactive arthritis syndromes and the immunologic role of infectious diseases as precipitants for clinical illness are incompletely understood. [unboundmedicine.com]

Bucala, MD, PhD, Editor Arthritis & Rheumatology (A&R), an official journal of the American College of Rheumatology, is a peer-reviewed publication for scientists and clinicians interested in the natural history, pathophysiology, treatment, and outcome [rheumatology.org]

Rheumatic fever is an important health problem in certain areas of the world, but it can be prevented by treating streptococcal pharyngitis as soon as it is recognized (i.e. primary prevention). [printo.it]

CONCLUSION: These data are consistent with prior studies and highlight the need for continued primary prevention efforts. [ncbi.nlm.nih.gov]

Specialty Care for Lupus People with lupus, a chronic autoimmune disease that can affect many parts of the body, often need specialized treatment to minimize their symptoms, reduce inflammation and pain and prevent organ damage. [tuh.templehealth.org]

Prevention The most effective way to prevent reactive arthritis is to avoid the most common infectious causes of the condition. [your.md]