Infectious involvements in males with Reiter's syndrome

To obtain data on infectious involvements contributing to joint attacks in Reiter's syndrome (RS) 72 consecutive males with RS were investigated. Controls were 219 personally interviewed males. A history of some type of oro-naso-pharyngeal or pulmonary infectious involvements were reported as often in the patients as in the controls, but the frequency of persons with a history of joint manifestations followed by these infections was significantly higher in the patients (23/72) than in the controls (8/219) (p less than 0.0001). Gastrointestinal involvements occurred only in a minority of cases as a triggering infection. Histories of prostatitis, gonorrhoea, condylomata acuminata, haematuria and trichomonas vaginalis infections were significantly more common in patients than in controls (p less than 0.001 - p less than 0.025). This finding, as well as evidence of chlamydial infection in 61%, speaks in favour of the importance of sexually transmitted diseases as an etiologic agent. A case report of triggering infections during the course of RS is given and the possible role of these infections in the immunopathogenesis in RS is discussed.