Presentation
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]
Jaw & Teeth
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Trismus
We present a case report of a four-year-old boy with torcicollis and trismus after acute otitis media. Grisel Syndrome diagnosis in association with temporo-mandibular reactive arthritis was admitted, leading to early conservative treatment. [ncbi.nlm.nih.gov]
Eyes
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Strabismus
[J Pediatr Ophthalmol Strabismus. 2016;53:e61-e63.]. [ncbi.nlm.nih.gov]
Ophthalmology, Sherbrooke University; Medical Director, Cornea Laser and Lasik MD Mounir Bashour, MD, CM, FRCS(C), PhD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus [emedicine.medscape.com]
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Retinal Lesion
Retinal lesions are not typically found in reactive arthritis. However, a previous case report documented co-existing retinal detachment and reactive arthritis. [ncbi.nlm.nih.gov]
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Ciliary Injection
The 28-year-old man visited the authors' hospital due to ciliary injection and hypopyon over left eye. On examination, Behcet-mimicking symptoms were observed, such as genital and oral ulcers and arthritis. [ncbi.nlm.nih.gov]
Musculoskeletal
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Arthritis
Gonococcal arthritis. Gout. Inflammatory bowel disease. Psoriatic arthritis. Rheumatic fever. Rheumatoid arthritis. Septic arthritis. [patient.info]
Arthritis occurring alone following sexual exposure or enteric infection is also known as reactive arthritis. [en.wikipedia.org]
A 10-year-old girl who was admitted to our hospital with low-grade fever, arthritis, and aching left eye with blurred vision was diagnosed with Reiter reactive arthritis. [ncbi.nlm.nih.gov]
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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]
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Joint Swelling
Reactive arthritis occurs when the body’s immune system reacts to a recent infection, usually within the past four to six weeks, with joint swelling and pain. [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]
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Joint Effusion
It is important to consider reactive arthritis, rather than solely an infectious cause of joint effusions, and arthropathy in a patient with a preceding or ongoing Staphylococcal infection. [ncbi.nlm.nih.gov]
effusions) Tendonitis/enthesitis of the lower limbs (achilles’ tendonitis/ plantar fasciitis) is also relatively common. [dundeemedstudentnotes.wordpress.com]
in patients with large joint effusions) Subsequent therapy for persistent disease Sulfasalazine (Azulfidine), 1 g two or three times daily Chronic therapy for erosive, deforming disease Methotrexate, 7.5 to 25 mg per week Azathioprine (Imuran), 100 [aafp.org]
Urogenital
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Cloudy Urine
The patient subsequently developed a fever over 38 C, pain on micturition, and cloudy urine 3 days following PCI. Urine cultures were positive for Escherichia coli and Enterococcus faecalis, whereas blood cultures were negative. [ncbi.nlm.nih.gov]
Workup
Reactive Arthritis Workup. Available online at . Accessed July 23, 2017. National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2016. Questions and Answers about Reactive Arthritis. Available online at . Accessed July 23, 2017. [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.medscape.com]
Treatment
OBJECTIVE: To examine the efficacy and safety of antibiotic treatments for reactive arthritis (ReA). METHODS: We did a systematic review and metaanalysis of randomized controlled trials of antibiotics for treatment of ReA. [ncbi.nlm.nih.gov]
Prognosis
The influence of new drugs on the short and long term prognosis of the patients with ReA remains to be evaluated. [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]
Etiology
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]
Epidemiology
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]
Pathophysiology
In this report, a case diagnosed with both reactive arthritis and osteopoikilosis will be presented and current arguments about its differential diagnosis and pathophysiology and concomitant disorders shall be discussed. [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]
Around 1-4% of patients get ReA after enteric infection Around 0.5-1% of patients with urethritis develop ReA Pathophysiology As with other seronegative arthropathies, there is an association with HLA-B27 allele of the MHC-class I protein. [dundeemedstudentnotes.wordpress.com]
Prevention
CONCLUSION: These data are consistent with prior studies and highlight the need for continued primary prevention efforts. [ncbi.nlm.nih.gov]
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]