Chlamydial Isolations and Serology in Reiter's Syndrome

Abstract

To assess the possible etiological link between genital infection due to Chlamydia trachomatis (CT) and Reiter's syndrome (RS) 24 men and 2 women with typical RS and 5 women with signs suggestive of RS (SRS) were examined. CT was isolated by irradiated McCoy cell culture technique and chlamydial indirect immunofluorescence serology was applied. Chlamydial isolation from the urethra was positive in 5 patients as well as from synovial fluid of the knee in one man. The serology was positive (titre greater than or equal to 64) in 17 (55%) of the 31 patients, including all 7 women. HLA-B27 antigen was detected in only 15 of 27 patients (55%). All except one of the 12 patients negative for HLA-B27 antigen had positive chlamydial serology. Among the patients were two married couples, both negative for B27 antigen and positive for chlamydial serology. The case report of the one couple, in which the wife had positive urethral chlamydial isolation, is given. Sexually acquired RS might easily be overlooked in women and be misdiagnosed as seronegative arthritis. The classification for RS associated with CT infection is discussed. The simultaneous treatment of the infection in sexual partners is emphasized.

Double‐blind, placebo‐controlled study of three‐month treatment with lymecycline in reactive arthritis, with special reference to Chlamydia arthritis

“…Our finding that prolonged treatment with lymecycline modifies the course of Chlamydia-triggered reactive arthritis and the results of previous studies showing Chlamydia antigen in joints (13,14,(29)(30)(31)(32) suggest that, in patients with ReA, Chlamydia may persist as a chronic infection. Because tetracycline has been shown to affect leukocyte function (33) and collagenolytic activity (34), further studies are needed to determine what role these effects might have in modification of the reactive arthritis course, among patients who receive the drug on a long-term basis.…”

Ten‐year followup study of patients with yersinia arthritis

“…Reactive arthritis is defined as sterile joint inflammation for which no triggering factor, either as a living cell or in the form of antigen, can be detected in the joint (21). However, there is increasing evidence that Chlamydia trachomatis can be either isolated (22) or detected by antigen in the synovial fluid or in the synovium (23). Consequently, a living or persisting Chlamydia could explain the rapidly progressive symptoms that are occasionally observed in Reiter's syndrome (13).…”

Are antibiotics of any use in reactive arthritis?

“…Chlamydia1 DNA and RNA have been detected by sensitive techniques in the joints (17,38,45). There are also a few reports on patients with chlamydia isolated from the synovial fluid (41,50). In contrast to chlamydia, only stable bacterial degradation products such as lipopolysaccharide (1 1, 12, 13, 32) and outer membrane proteins (1 1, 17) have been detected.…”