Is Reiter's syndrome caused by chlamydia?

Chlamydiae as pathogens--an overview of diagnostic techniques, clinical features, and therapy of human infections

Chlamydiae are Gram-negative bacteria with obligate intracellular reproduction and disability to synthesize high-energy compounds such as ATP. Their cycle of development is unique among the prokaryotes: the host cells, mainly epithelial cells, are infected by so-called elementary bodies (EB) which undergo reorganization to form metabolically active reticulate bodies (RB). These RB multiply by binary fission, and after transition into infectious EB they are released within 48-72 hours. Chlamydiae cause prolonged subclinical infections of the conjunctiva, lung, cervix, and urethra. Complications in newborns are inclusion conjunctivitis, nasopharyngitis and pneumonia; in females, salpingitis, infertility, and perihepatitis; in male patients, epididymitis and prostatitis; and in both sexes, Chlamydiae-induced arthritis. Identification of the pathogenic agent confirms clinical diagnosis; tissue culture identification remains the diagnostic method of choice. Therapeutical drugs are tetracycline, erythromycin, josamycin, and in certain cases quinolone derivatives.

Follow-up study of Reiter's disease and reactive arthritis. Factors influencing the natural course and the prognosis

The acute clinical picture and long-term prognosis of 160 patients with Reiter's disease (RD), and 144 patients with reactive arthritis triggered by yersinia infection (YA), was analysed. Most of the patients with RD were men, while YA was as common among male and female patients. YA manifested in a third of patients as incomplete or complete RD. The long-term prognosis in RD was less favourable than in YA. Recurrent arthritis, development of chronic destructive arthritis and radiologic sacroiliitis were more frequent in RD than in YA. The presence of HLA-B27 was the major factor determining extra-articular inflammatory symptoms and the development of chronic problems.