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Reiter's is a seronegative, HLA-B27-linked spondyloarthropathy (autoimmune damage to the cartilages of joints) often precipitated by genitourinary or gastrointestinal infections. It is more common in men than in women and more common in white men than in black men. People with HIV have an increased risk of developing Reiter's as well.
It is set off by a preceding infection, the most common of which would be a genital infection with Chlamydia trachomatis. Other bacteria known to cause Reiter's are gonococcus , Ureaplasma Urealyticum , Salmonella, Shigella, YersiniaYersinia is a genus of bacteria in the family Enterobacteriaceae. Some members of Yersinia are pathogenic in humans. Species include Yersinia pestis Y. entercolitica and Y. pseudotuberculosis''. Proteobacteria., and Campylobactersee text Campylobacter is a genus of Gram-negative bacteria. Species Campylobacter fetus Campylobacter jejuni Campylobacter coli Campylobacter sputorum Campylobacter mucosalis Campylobacter concisus Campylobacter nitrofigilis Campylobacter laridis Campylo. A bout of food poisoning or a gastrointestinal infection may also set off Reiter's (those last four bacteria mentioned are enteric bacteria). Reiter's usually manifests about 1-3 weeks after a known infection.
Symptoms generally appear within 1-3 weeks but can range from 4-35 days from onset of inciting episode of disease.
The classical presentation is that the first symptom experienced is a urinary symptom such as burning pain on urination ( dysuriaIn medicine, specifically urology, dysuria refers to any difficulty in urination. It is sometimes accompanied by pain. It is most often a result of an infection of the urinary tract. In men, the urinary system overlaps with the reproductive system, so dys) or an increased need to urinate ( polyuriaPolyuria is the passage of a large volume of urine in a given period, a characteristic of diabetes. or frequencyFrequency is the measurement of the number of times that a repeated event occurs per unit time. To calculate the frequency, one fixes a time interval, counts the number of occurrences of the event within that interval, and then divides this count by the l). Other urogenital problems may arise such as prostatitis in men, and cervicitis, salpingitis and/or vulvovaginitis in women.
The arthritis that follows usually affects the large joints such as the knees causing pain and swelling with relative sparing of small joints such as the wrist and hand.
Eye involvement occurs in about 50% of men with urogenital Reiter's and about 75% of men with enteric Reiter's. Conjunctivitis and uveitis can cause redness of the eyes, eye pain and irritation, and blurred vision. Eye involvement typically occurs early in the course of Reiter’s syndrome, and symptoms may come and go.
Roughly 20 to 40 percent of men with Reiter’s syndrome develop penile lesions called balanitis circinata on the end of the penis. A small percentage of men and women develop small hard nodules called keratoderma blennorrhagica on the soles of the feet, and less often on the palms of the hands or elsewhere. In addition, some people with Reiter’s syndrome develop mouth ulcers that come and go. In some cases, these ulcers are painless and go unnoticed.
About 10 percent of people with Reiter’s syndrome, especially those with prolonged disease, will develop cardiac manifestations including aortic regurgitationand pericarditis.