Reiter's Syndrome

[BenG]

Hi, many thanks for your time. I have posted once before but I have some new symptoms. I won't post again after this.

I was diagnosed with urtheritis (non-chlamydia, non-gonorrhea).

Symptoms began 11 weeks ago. Started six week course of doxycycline 100mg/day only 3.5 weeks ago (delay was because doctors couldn't find any bacteria so thought it wasn't anything). Only my urologist decided to give me treatment).

Over the past 1.5 weeks (9 weeks post onset of urethral symtoms), I have been getting muscular/joint pain. Started with right buttock, then upper arms, now fingers on both hands, right ankle, lower neck, lower back. Symptoms are quite mild (no pain killers taken) and fluctuate.

I have had some eye symptoms but not conjunctivitis - a kind of non-specific haziness (lack of clarity of vision). Went to eye hospital, had a look into my eyes with machinary & drops but nothing.

The antibioitics are not resolving the urethral symptoms so I am going get a different urologist's opinion tonight.

1. Do you think this could be Reiter's syndrome?

2. Am I going about this the right way (pursuing 2nd urological opinion)

3. I heard diagnosis of Reiter's is purely clinical. How can I ensure I get an accurate diagnosis?

4. I am going to ask the urologist to test for HLA-B27. Is this a good idea?

Thanks so much.
Ben (England)

[H. Hunter Handsfield, M.D.]

Your symptoms sound too vague for Reiter's syndrome; I doubt you have it.  Unless/until there is better clinical evidence of that diagnosis, I do not recommend HLA-B27 testing.  (5-20% of the European population is HLA type B27; so even if positive, it won't mean you have RS.)

I can't comment with great knowledge about urologists' STD expertise in UK, but in the US it is quite low.  Further, I doubt UK urologists in general are up to date on Reiter's syndrome.  You'll probably do better by seeing a GUM specialist.

Good luck--  HHH, MD

[brianturner]

hi ben, i too am having unresolved problems and i am interested in why they diagnosed urtheritis because i have an ache but no other symptoms and  the GUM clinics can't find a bacterial infection, did you have any other symptoms?

[BenG]

Hi Brian.
Well, I had oral sex and 8 days later I started getting a burning sensation when urinating.
I got tested at two different GUM clinics and all tests were negative (Chlamydia, gonhorrea, NSU, etc..).
It was fustrating because they kept saying there is no infection but I knew there must be a reason for it.
So I went to a urologist and said it is a bug causing it but a low grade organism (not one you can grow).
I am not off to a second uroligst to shed some light on these new symptoms!
Where did you get tested?

[H. Hunter Handsfield, M.D.]

I recommend you follow the diagnosis and advice of the GUM clinics you have seen.  The diagnosis of no infection is much more likely to be correct than your urologist's diagnosis of a "low grade organism" than cannot be grown on culture.  I suspect your symptoms are due to heightened anxiety that is magnifying normal body sensations,  not to Reiter's or any active infection.

HHH, MD