A 27-year-old man complains of pain in his leg joints, purulent discharge from the eyes, and painful burning sensations during urination. Disease onset was acute. He has a history of influenza. The patient smokes and drinks alcohol in excess. In his line of work he is often away on business trips. What is the most likely etiological factor of this disease?

Answer options

1. Streptococci
2. Chlamydia
3. Adenovirus
4. Candida
5. Staphylococci

Explanation

Anytime you get a Rheumatology case like this with urethritis or cervicitis, just think of Reactive arthritis (Reiter's syndrome). This is a form of inflammatory arthritis that develops in response to an infection in another part of the body (cross-reactivity). The manifestations of reactive arthritis include the following triad of symptoms: inflammatory arthritis of large joints, inflammation of the eyes in the form of conjunctivitis or uveitis, and urethritis in men or cervicitis in women. The most common triggers are intestinal infections (with Salmonella, Shigella, or Campylobacter) and sexually transmitted infections (with Chlamydia trachomatis).