Reiter's syndrome complicating Salmonella enteritidis infection

Salmonella-triggered reactive arthritis

Clinical significance of Salmonella-triggered reactive arthritis is rising, because the frequency of Salmonella infections is increasing all over the world. In this study reports on Salmonella-triggered reactive arthritis have been reviewed. A summary of clinical, epidemiological and laboratory data, as well as triggering serotypes, is presented. Diagnostic and therapeutic aspects are also discussed.

Serological diagnosis of salmonella infections by enzyme immunoassay

An enzyme immunoassay (EIA) for the detection and measurement of serum IgM, IgG, and IgA antibodies to salmonella was developed with commercially available lipopolysaccharides (LPSs) of Salmonella typhimurium and S enteritidis combined as antigen. Of 130 sera from patients with culture-confirmed salmonella infections, 115 (88.5%) were positive in this assay. The classic Widal agglutination test was positive in only 50 (38.5%) cases. This EIA method offers a substantial advance in the serological diagnosis of acute salmonella infections; it detects antibodies to the salmonellae of groups B and D, which constitute about 70% of culture-positive cases of human salmonellosis. Antibodies to other salmonellae are also detected. This EIA is particularly valuable for the detection of salmonella antibodies during post-infectious complications when isolation of the organism is often no longer possible.

Evidence for Chlamydia trachomatis and Ureaplasma urealyticum in a patient with Reiter's disease

An adolescent female with Reiter's disease and positive for HLA-B27 is presented. Chlamydia trachomatis was cultured from the eye and Ureaplasma urealyticum and Mycoplasma were isolated from the urogenital tract. Joint and serologic evidence for Chlamydia and Ureaplasma were present. A brief review of Reiter's disease in children and adolescents is discussed.

Postdysenteric reactive arthritis. A clinical and immunogenetic study following an outbreak of salmonellosis

Following an outbreak of foodborne gastroenteritis caused by Salmonella typhimurium, questionnaires were sent to affected individuals and then to the family physicians of any who experienced extra-enteric complications. Of 260 individuals infected with S typhimurium for whom adequate data were obtained, 19 patients developed joint disease (7.3%). All were men; the mean age +/- SD was 39.3 +/- 1.6 years. Among the 16 patients for whom this information was available, the interval from the onset of diarrhea to the onset of joint pain was less than 7 days in 7, 8-21 days in 2, and greater than 21 days in 7. There was a significantly longer duration of diarrhea in those patients with joint disease (mean +/- SEM 15.2 +/- 2.6 days) than in those without complications (10.0 +/- 1.1 days) (P less than 0.01). The joint disease was monarticular in 3 patients and polyarticular in 16. The joints most commonly affected were the elbow (47%), wrist (47%), knee (42%), low back (32%), and shoulder (32%). Six of the 19 patients had at least 1 extraarticular feature: ocular (5 patients), mucosal (1 patient), urethral (2 patients), or cutaneous (1 patient). Of these 19 patients, 11 were located and agreed to HLA typing. Four were positive for HLA-B27, 6 were HLA-B7 positive, and 1 had HLA-Bw60. Of the 4 B27 positive patients, 3 were DR1 positive; of the 6 B7 positive patients, 5 were DR2 positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Followup study on patients with Reiter's disease and reactive arthritis, with special reference to HLA-B27

An analysis of 160 patients with Reiter's disease, 144 with yersinia arthritis, and 9 with salmonella arthritis was performed, Complete or incomplete Reiter's syndrome was observed in one-third of the patients with yersinia arthritis and in most of those with salmonella arthritis. During the followup period, chronic back pain and joint symptoms were frequent in all the patient groups. Patients who were HLA-B27 positive had a more severe acute disease (more frequent back pain, urologic symptoms, mucocutaneous manifestations, and a longer duration of the disease) and more frequent chronic back pain and sacroiliitis.

Ocular inflammation in Reiter's disease after Salmonella enteritis

We studied characteristics of ocular inflammation in Reiter's disease after Salmonella enteritis in eight patients. After an acute onset with diarrhea, fever in six patients, and headache in three patients, all patients developed arthritis; six patients had myalgia; six patients, urethritis; and one patient, carditis. Sacroiliitis was found in four patients. All patients had HLA-B28 antigen. Conjunctivitis occurred in seven patients. It was mostly mild with no chemosis, follicles, or keratitis, and resolved in ten days. In one case palpebral edema, chemosis in the conjunctiva, and purulent exudate were seen. One patient had transient episodes of keratitis and corneal erosion for two months and episodes of conjunctivitis for 11 months. Three patients developed unilateral acute anterior uveitis with aqueous flare, cells, fine keratic precipitates, and fibrinous exudation from three to four years after the onset of the illness. One of these patients had vitritis and macular and papillary edema.