Symptoms
In the case of a Reiter syndrome, the so-called Reiter triad is described. Possibly these can be completed by a further symptom to the Reiter triad. Arthritis, inflammation of the ureteral mucosa (urethritis) and conjunctivitis (conjunctivitis) or iritis are among the Reiter triad: The Reiter triad also includes the so-called Reiter dermatosis: This dermatosis is an erythema, a reddening of the skin, which occurs similar to psoriasis on the mucous membrane of the male sexual organ, as well as lesions of the oral mucosa.
In addition, this dermatosis causes changes in the palms of the hands and soles of the feet, so-called keratoma blenorrhagicum, which manifests itself with pus-filled blisters. There may be further skin changes all over the body, which resemble psoriasis in their appearance. During a Reiter syndrome, accompanying symptoms may also occur in addition to the typical Reiter triad.
These are variable and include fever, an inflammatory change in the joints of the lower spine (sacroiliitis), painful inflammation of the tendon attachments (enthesiopathies) or, more rarely, inflammation of internal organs such as the heart (carditis) or the lung skin (pleuritis).
- Arthritis describes an acute inflammation of one or more joints. It usually occurs asymmetrically, i.e. not on the same side.
Arthritis in Reiter’s syndrome preferentially affects the lower extremity, i.e. the knee or ankle joints.
- Urethritis describes the inflammation of the urethra. It is characterized by itching and pain when urinating. Likewise, an outflow or reddening of the urethral orifice can be noticed.
- Conjunctivitis is the conjunctivitis of the eyes.
It is characterized by reddening of the eyes. A foreign body sensation in the eye is described and the eyes water more frequently.
- Iritis would be an inflammation of the iris of the eye. Again, the eye appears reddened, and compared to conjunctivitis, light sensitivity, pain and blurred vision occur.
The therapy of Reiter’s syndrome depends on the infection situation and germ.
If the infection is still acute, various antibiotic treatments may be indicated. This is not the case if no pathogen can be detected at present. In the case of a proven urinary tract infection by Chlamydia or Ureaplasma, the antibiotics Doxycyclin or macrolides such as Erythromycin or Clarithromycin can be considered.
Particularly with an infection by Chlamydien an antibiotic therapy is recommended, since this germ can persist in the body. It is important that with a Chlamydieninfektion always the partner because of a renewed danger of infection must be also treated! Also in the case of an acute proven Gonorrhoe (Tripper) or a stomach intestine infection an antibiotic therapy appropriate for the pathogen is recommended.
If no more infections are detectable, one can also treat symptom-oriented. Thus with an acute Arthritis non-steroidal antirheumatics are used. Likewise inflammation-retardant should be worked here with a so-called cold application (cryotherapy).
Both therapies help against the symptoms of arthritis. If the course of the disease is more severe, affecting several different joints, or if there is a severe inflammation of the inner eye (iridocyclitis), therapy with glucocorticosteroids (cortisol) should be started. If Reiter’s syndrome persists and a chronic course occurs, the administration of sulfasalazine is indicated.
This has an additional anti-inflammatory effect. The only prophylaxis for the occurrence of Reiter’s syndrome is the effort to prevent infection of the urinary tract or the gastrointestinal tract. If an infection does occur, it should be treated as soon as possible.
