Lessons to be Learned About Reiter's Syndrome

QUESTION: A recent visit to my physician, because of a painful knee, resulted
in an embarrassing set of questions about my sex life. I resisted answering
until the doctor, after looking in my eyes, insisted. When we were through, I
found out a lot about myself, and more respect for your profession. Why not
tell your readers about Reiter's Syndrome; there are a lot of lessons to be
learned.
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ANSWER: Your suggestion is a welcome one, and the disease you suggest
certainly can help to make a lot of very important points about medical care.
Before we start, a complimentary word for your physician (and a personal hello
from me). He was not only astute, but displayed a great many of the qualities
we all desire in our own personal physicians. His persistence in questioning
was appropriate and artful, and when he discovered your conjunctivitis, the
possibility of a diagnosis of Reiter's Syndrome (RS) was increased. RS occurs
primarily in young men between the ages of 20 and 40. Typically it displays
three main symptoms or signs, an arthritis, a conjunctivitis, and a urethritis
(inflammation of the passage within the penis that carries the urine). The
urethritis produces a burning sensation during urination, but not as severe as
when the cause of the inflammation is a bacterial infection. There are some
studies that indicate that there may be an inherited factor which makes some
individuals more susceptible to the disease than others. However, the most
important factor is that this is classifiable as a sexually transmitted
disease, thus the queries put to you by your physician. It probably is
associated with an infection by the C. trachomatis bacteria passed on by a
sexual partner. The symptoms come on 7 to 14 days after contact. Initially
there is a low grade fever, possibly some diarrhea. The conjunctivitis and
arthritis follow over the next few weeks. Occasionally there are small skin
lesions. When trachoma infection can be identified as the source, treatment
with antibiotics, erythromycin or tetracycline is recommended over a 10 day
period. And the sexual partner must be treated as well. The initial episode
will resolve in 3 to 4 months, but over half the patients will experience some
brief arthritic symptoms as well as the other components of this syndrome over
a period that can cover years. A lesson to be learned for sure, good doctors
sometimes ask questions that are difficult to respond to, but the reasons here
are now obvious.