An "experimental" epidemic of Reiter's syndrome

Nine cases of Reiter's syndrome followed 602 cases of proven bacillary dysentery, while none of an equally large group escaping dysentery developed Reiter's disease. All patients were observed from the ingestion of Shigella until their initial return to duty. Venereal disease was excluded as a causative factor. Antibiotics, antihistaminics, and steroids proved ineffective. We have concluded that Reiter's disease may occur as a sequella of bacillary dysentery, with a definite time relationship between the two disorders, that severe conjunctivitis appears to herald severe or recurrent arthritis, and that arthritis seems worst in joints previously weakened by other disease. If initial disability lasts over three months, permanent or recurrent disability is likely, and recurrence is presaged by a rise in the erythrocyte sedimentation rate.