REITER SYNDROME -
Dejan Veljković1, Momcilo Mirković2, Natasa Rančić3, Ljubomir Stefanović4
1Ministry of Internal Affairs, Gendarmerie Detachment in Kraljevo, Serbia, 2University of Pristina, Faculty of Medicine, Department of Preventive Medicine, Serbia,3University of Nis, Faculty of Medicine, Department of Infectious Diseases and Epidemiology, Serbia, 4Health Center “Studenica”, Kraljevo, Serbia
INTRODUCTION: Reiter's syndrome is a seronegative arthritis that occurs after an acute, nonspecific urogenital or digestive infection. It is characterized by asymmetric arthritis of the legs, changes in the eye (conjunctivitis or anterior uveitis) and changes in the skin (keratoderma blennorrhagicum) and mucous membranes (balanitis, stomatitis). According to previously established criteria, the existence of a classic Reiter's triassic or tetrad is necessary for diagnosing this syndrome.
AIM: The aim of the study was to present a patient with an atypical clinical manifestation of Reiter's syndrome, which consisted of only one symptom, and which was masked by an injury to the toes.
CASE REPORT: Patient D.R. at the age of 34, a member of the Gendarmerie, after a fall due to injuries to the toes of his left foot and pain in the lumbar part of his back, he went to an orthopedist, treated as Dg. Contusio partium pedis aliarum, non specificatum. On the radiology image of the left foot, the finding is neat. Anamnestic data show that during his stay in the field 3 weeks ago, he had a fever, which lasted for a week, and that he had frequent liquid stools during that period. He had no dysuric disorders or conjunctivitis, without a positive family history of rheumatic diseases. In standard laboratory blood tests showed elevated SE (55 mm / 1h) and CRP (67.5 mg / L) and other findings and analysis of urine within the reference range. Within 15 days of the injury, swelling on individual joints of both hands and swelling of the right knee also occured. He was referred to a rheumatologist, when Reiter's syndrome was first suspected. Initiated treatment was with glucocorticoids, antibiotics and nonsteroidal antirheumatic drugs, systemically and locally. The patient underwent HLA B 27 typification, which is positive, and was diagnosed with rheumatic disease from the group of chronic spondyloarthropathies, the closest to Reiter's syndrome.
CONCLUSION: We found that Reiter's syndrome is still a challenge for timely diagnosis, because it occurs a few weeks after the primary infection and can remain unrecognized. A special problem is the existence of only one symptom, which is manifested only by arthritis. A well-
Key words: Reiter syndrome, arthritis, injury, anamnesis.
Ministry of Internal Affairs,
Gendarmerie Detachment in Kraljevo, Serbia
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