The syndrome most frequently follows genitourinary infection with Chlamydia trachomatis , but other organisms have also been implicated. Treatment with doxycycline or its analogs sometimes shortens the course or aborts the onset of the arthritis. Reactive arthritis may also follow enteric infections with some strains of Salmonella or Shigella, but use of antibiotics in these patients has not been shown to be effective. Reactive arthritis should always be considered in young men who present with polyarthritis. Symptoms may persist for long periods and may, in some cases, cause long-term disability.
Initial treatment consists of high doses of potent nonsteroidal anti-inflammatory drugs.
I n 1984 in Ontario, Canada, an outbreak of Salmonella typhimurium food poisoning occurred among police officers who were serving as security guards during a papal visit. The remaining 18 officers had recurrent symptoms or had developed a chronic arthritis on re-evaluation five years later. These officers had developed reactive arthritis, or Reiter's syndrome. Although this condition was once considered benign and self-limited, that may not always be the case. We review the current understanding of this illness and implications for treatment.