Reiter's Disease with Unusual Clinical Manifestation

Abstract

28 years old married male hotel worker had 16 months before the onset of Reiter's disease a self limited severe diarrhoea and 12 months before a venereal exposure. The urethritis that followed a few days after exposure was treated immediately. The symptoms of Reiter's diseasestarted acutely with high fever, hamoptysis and a shadow in the left lung. During the of the disease, patient developed urethritis, polyarthritis, transient conjunctivitis, skin lesions, high ESR and persistent poly-morphotiuclear leucocytosis. Joints of the upper limbs were involved to a greater extent than those of lower limbs. Skin lesions were absent on the soles of the feet but were present symmetrically on the shins and to a greater extent around the elbows. Administration of steroids resulted in dramatic improvement, but, its cessation was followed by relapse of clinical features, rise in ESR leucocyt6si@, reactivation and spread of the pulmonary lesions. Pulmonary symptoms dominated the entire course of the disease. Haemoptysis was the presenting symptom and was responsible for the death of the patient.