One of the complications of chronic chlamydia is Reiter’s disease, which is a complex lesion of the genitourinary system, joints and mucous membrane of the organs of vision. Usually, a person simultaneously or sequentially develops urethritis, polyarthritis and conjunctivitis.
The main reason for the development of pathology is the autoimmune process, which is provoked by the microorganisms Chlamydia trachomatis, as a result of which the human immune system is disrupted. Usually, Reiter’s disease in women is observed twenty times less than in men, due to the multiple sexual relations of the latter. Most often, pathology develops in military personnel and homosexuals.
Disease characteristic
Reiter's disease is a rheumatic disease that combines the simultaneous or sequential damage to the organs of the genitourinary system, joints and eyes. Typically, a disease develops as a result of exposure to the organism of Chlamydia trachomatis bacteria, which enter it through sexual or contact-household routes. Chlamydia can parasitize in the cells of an infected person for a long time. In some cases, the development of pathology is provoked by infections such as salmonellosis, ureaplasmosis.
Doctors suggest that Reuters syndrome pathogens with an antigenic structure contribute to the occurrence of certain immune system reactions in people with a genetic predisposition.
When infected with chlamydia in the organs of the genitourinary system (urethra, prostate or uterus), inflammation appears, from this focus pathogenic bacteria with blood flow spread to tissues, including articular, contributing to the development of autoimmune allergies.
Types of disease
Reiter’s disease in men and women has two stages:
- infectious, in which chlamydia enter the urethra;
- immunopathological when pathology of the joints and conjunctiva develops.
There are also two forms of pathology:
- Sporadic, in which the disease is preceded by a sexually transmitted disease.
- Postenterocolitic form, when pathology is preceded by enterocolitis caused by ureaplasma, salmonella, dysentery, shigella or yersinia.
The disease can last from six months (acute stage) to one year (prolonged stage), then it becomes chronic.
Epidemiology
Reiter's disease is the most common joint pathology of the inflammatory nature in young men, less often the disease affects women and children. The latter usually become infected at birth from an infected mother.
In 90% of cases, pathology was detected in the sexual partners of infected people. This disease can be inherited. Usually, Reiter's syndrome develops in those who carry the HLA B27 antigen. According to statistics, the disease manifests itself in men and women in a ratio of 10: 1.
Causes of the development of the disease
Most often, the disease develops due to Chlamydia trachomatis bacteria, which, when exposed to unfavorable factors on the body, transform into the L-form, which can parasitize inside healthy cells for a long period of time. This contributes to the development of a chronic form of the disease, which provokes the appearance in men of urethritis, and in women of cervicitis, cystitis or salpingitis. Women who have these pathologies and are carriers of chlamydial infection rarely have arthritis of a urogenic nature.
With the bloodstream, chlamydia is carried throughout the body, settling in organs and tissues, so the disease has several lesions. The infection is transmitted through sexual and domestic transmission. It can be found on the mucous membrane of the urethra, the cytoplasm of the synovia and conjunctiva cells. In some cases, Reiter's disease (photo is provided in the article) is provoked by salmonella, shigella and appears after enterocolitis. In 95% of cases, the pathology is inherited.
Symptoms and signs of pathology
Reiter’s disease does not show symptoms at once. In 40% of people, the first signs of the disease appear three months after infection. First, there is a lesion of the organs of the genitourinary system, and the symptoms are mild. Then arthritis and conjunctivitis develops. Usually, people first come to the therapist and ophthalmologist who conduct treatment that does not give results due to the fact that the urogenital infection is not taken into account.
Usually, the pathology is manifested by a triad of signs: a disease of the genitourinary system, arthritis and conjunctivitis. In some cases, the mucous membranes of the oral cavity are affected, as a result of which stomatitis or glossitis develops, and the penis, causing the appearance of balanitis or balanoposthitis.
Also, pathology affects the skin in 50% of cases. It forms red papules, areas of hyperemia with peeling and cracks. Typically, such phenomena are observed on the skin of the palms and feet. Often, the nervous and cardiovascular systems are included in the pathological process. Perhaps the development of pneumonia, nephritis, pleurisy, myocarditis and other ailments.
With a prolonged course of the disease, an increase in body temperature to high rates is possible, intoxication of the body is observed, anemia, muscle atrophy develops, weight loss. With a complex form of pathology, a violation of the functionality of the joints, visual impairment, erection, infertility develops, and lymph nodes increase. Later, the kidneys, heart and aorta, as well as the nervous system, are affected.
Reiter's disease has a wide variety of symptoms, which are expressed in different ways. Usually, after the first attacks of the disease, recovery occurs, but sometimes it becomes chronic. Also, the pathology can recur, showing not all possible symptoms. Therefore, it is necessary to begin treatment of the disease in a timely manner.
The defeat of the genitourinary system
First, the disease affects the genitourinary organs. Reiter's disease in men is mild. Representatives of the stronger sex develop urethritis and prostatitis, diseases can occur for several years. Sick people experience discomfort and signs of hyperemia in the urethra, scanty mucus, dysuric disorders, itching and burning in the urethra can be observed. Rashes on the genitals are usually diagnosed incorrectly, doctors confuse them with psoriasis.
Reiter's disease manifests symptoms in women in the form of cervicitis or andexitis, which occurs without any signs. With this course of the disease, the presence of an inflammatory process is detected on the basis of laboratory data. In the smear, an increase in the number of leukocytes is detected.
Damage to the organs of vision
Two weeks after urethritis, conjunctivitis develops, in some cases, iritis, uveitis, retinitis or keratitis can be observed. Usually, symptoms appear for seven days, but there are also protracted forms of the disease. Signs of Reiter's disease can be mild, in severe cases, a decrease in visual acuity or the development of blindness is possible. Many doctors claim that damage to the organs of vision can occur as a result of infection through dirty hands from the genitals.
Joint damage
Reiter's disease, the symptoms and treatment of which will be discussed below, also manifests itself in the form of reactive arthritis, which occurs one month after the defeat of the genitourinary system. Joints of the legs are asymmetrically involved in the pathological process. Usually the skin in the area of ​​the affected joints is hyperemic, an effusion is formed in the cavities. Over the course of several days, proximal and distal joints are affected, while arthralgia is more pronounced in the morning and evening.
With arthritis, swelling, deformation of the fingers, discoloration of the skin are observed. Often, bursitis, calcaneal spurs, tendonitis, sacroileitis develop, which provoke the appearance of pain at night. Sometimes pain can develop in the spine, flat feet form.
In half of the patients, the signs of the disease completely disappear, in 30% of people arthritis recurs over time, in other cases the disease proceeds in a chronic form, which is characterized by muscle atrophy and impaired joint mobility.
Diagnostics
During the diagnosis, the symptoms may not appear completely, since a period of time passes between the defeat of the three components. Therefore, it is not always possible to determine the relationship between the defeat of the genitourinary system, joints and organs of vision.
Today, no specific tests have been developed to diagnose pathology. Diagnostic signs of the disease include acute arthritis of the lower extremities, inflammation in the genitourinary system and organs of vision, damage to the epithelium and skin.
A doctor to determine these signs prescribes laboratory tests of blood, urine, a smear test and prostate secretion. A cytological study of scrapings of the epithelium of the urethra, cervix, conjunctiva and synovial fluid for the presence of chlamydial infection. In this case, the Romanovsky-Giemsa test is used, which has a sensitivity of 95%. Also for this purpose, PCR, RNGA, IFA and RSK are appointed. The main sign of pathology is the detection of HLA 27 antigen. Joint radiography is used as an instrumental diagnosis.
The doctor differentiates Reiter’s disease with diseases such as rheumatoid and psoriatic arthritis, ankylosing spondylitis, gonorrhea arthritis, rheumatic heart disease, brucellosis arthritis and so on.
Disease therapy
Reiter's disease treatment involves a comprehensive. At the same time, both sexual partners should undergo treatment. The doctor develops the following treatment tactics:
- Therapy with antibacterial drugs to eliminate the source of infection.
- Anti-inflammatory joint treatment.
- Immunocorrection.
Reiter's disease antibiotic treatment includes three courses lasting three weeks each. For this, the doctor prescribes drugs from the group of tetracyclines, macrolides, fluoroquinolones. In the presence of chronic chlamydia, Doxycycline is often prescribed. At the same time, it is necessary to take antifungal drugs, vitamins, hepatoprotectors and enzymes, immunomodulators, adaptogens. In severe cases, detoxification therapy and antihistamines are prescribed.
To treat joints, the doctor prescribes NSAIDs and often carries out joint puncture with glucocorticosteroids introduced into his cavity. Then a compress is applied with a solution of an anesthetic and an anti-inflammatory ointment. After eliminating the symptoms of arthritis, treatment of Reiter’s disease in men and women involves the appointment of physiotherapy, massage, rhodone baths, UHF, and more.
If necessary, the doctor may prescribe sedatives or tranquilizers. Psychotherapy is often carried out aimed at developing a person's attitude toward recovery. In the presence of depression, antidepressants from the group of SSRIs, electro sleep are prescribed.
Definition of recovery
An experienced doctor will tell you what symptoms and treatment suggest Reiter's disease (a photo of the disease is attached above). In the treatment of pathology, the patient should be under the constant supervision of a physician. The first re-diagnosis is carried out one month after the end of therapy, the second - three months later. Then a person should be examined every six months for three years. This is necessary to exclude the development of relapses in the chronic form of the disease. Such patients should be under the supervision of a urologist, optometrist, and dermatovenerologist. Such measures are necessary for timely treatment in case of a threat of late complications.
Forecast and Prevention
The prognosis of the disease is usually favorable. In half of the patients, the disease turns into remission after six months, but the risk of relapse remains. In one fourth of patients, arthritis acquires a chronic form, provoking a violation of the functionality of the joints, the development of flat feet and muscle atrophy.
Prevention of pathology is aimed at preventing the development of STDs, intestinal infectious diseases, timely treatment of enterocolitis and urethritis.
Reiter's disease develops sharply, but proceeds benignly, periods of exacerbation alternate with unexpected remissions. It is important to undergo a timely examination to identify the causes of poor health, in order to be able to undergo effective treatment and get rid of the pathology. Doctors recommend leading a healthy and proper lifestyle, having one permanent sexual partner.