DrVirgo
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A 25 year old white male presented with polyarthralgias, and severe heel pain. He discloses that he had a sexual intercourse with a prostitute; since then he started having urethral discharge. On examination all his digits are diffusely swollen and appears like "sausage" digits. Gram stain of the urethral discharge and joint aspiration is negative for organisms. Which of the following is the most appropriate next step in the management of this patient?
A. Treatment with corticosteroids
B. Treatment with NSAIDS
C. Treatment with ceftriiaxone IM one dose
D. Draw blood cultures
E. Treatment with methotrexate
ALSO say what his diagnosis is!!!
Thanks.
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| prasannakumar
Forum Senior
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Reiter's
B.NSAIDS
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| Aashi
Forum Moderator
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Urethritis,arthrits and arthralgias, and no organisms in urethral discharge---->Reiters--->TOC---->NSAIDS ----> B
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| dr in trouble
Forum Guru
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NSAIDS
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| elitoki
Forum Guru
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Could anyone tell me if "sausage digit" is tipical clinical manifestation for Reiter's disease?
I know that the triad of "Can't See, Can't Pee, Can't Climb a Tree" helps to dx for Reiter's disease, but when they said sausage digit make me think about psoriatic arthritis.
Thanks
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| Hotobhaga
Forum Elite
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right Eltoki... also there is no dysuria no eye symptoms hlA B 27. Not enough data to say it is reiters
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| sprint123
Forum Guru
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To diagnose Reiter's -----It is NOT necessary to have all the 3 criteria----EVen with urethral discharge only we could diagnose Reiter's in appropriate situation---
Sausage digit is characteristic of Psoriasis but can also occur in Reiters!
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| DrVirgo
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B is right... Good job everyone!
Another question: Can gonococcal infection be a cause of Reiters syndrome?
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| sprint123
Forum Guru
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It is usually Non-gonococcal urethritis causing reiter's!
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| ssrpk
Forum Fanatic
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no
reactive arthritis after Salmonella,shigella, campylobacter, yersinia and chlamidia trachomatis
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| DrVirgo
Forum Hero
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right, for the diarrhea all the organisms which cause enteroinvasive diarrhea...
And the non-gonococcal arthritis can occur with chlamydia and ureaplasma.
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