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Marler Blog Providing Commentary on Food Poisoning Outbreaks & Litigation

Medical Complications that can arise from a Salmonella Infection – Reiter’s Syndrome and Reactive Arthritis

People infected with Salmonella usually recover without medical treatment in six to ten days. It may be several months, however, before their susceptibility to diarrhea and gastrointestinal distress fully resolve. “Although younger individuals usually face far higher infection rates from these pathogens, older adults are more likely to have more severe complications.” In addition, “the elderly are far more susceptible to death from Salmonella infections than the general population.”

A variety of other medical problems may derive from Salmonella infections in any given case. Within several months of infection, a certain percentage of ill individuals will develop an arthritic condition known as reactive arthritis, or “Reiter’s Syndrome,” which results from an immune response to the Salmonella bacteria in the body where the immune system attacks the cartilaginous tissues in the joints. The condition frequently resolves within several months, but it can become chronic, even permanent.

Reiter’s Syndrome, which includes, and is sometimes referred to as reactive arthritis, is an uncommon, but debilitating, possible result of a Salmonella infection. Reiter’s Syndrome is a disorder that causes at least two of three seemingly unrelated symptoms: “reactive” arthritis, eye irritation, and urinary tract infection. The reactive arthritis associated with Reiter’s develops when a person eats food that has been tainted with bacteria. Reactive arthritis is characterized by the inflammation of one or more joints, following an infection localized in another portion of the body, commonly the gastrointestinal tract. The symptoms of Reiter’s Syndrome usually occur between one and three weeks after the infection.

The three most common symptoms of Reiter’s Syndrome are arthritis, eye irritation, and urinary tract symptoms. The arthritis associated with Reiter’s Syndrome typically affects the knees, ankles, and feet, causing pain and swelling. Wrists, fingers and other joints can be affected, though with less frequency. Patients with Reiter’s Syndrome commonly develop inflammation where the tendon attaches to the bone, a condition called enthesopathy. Some patients with Reiter’s Syndrome also develop heel spurs, bony growths in the heel that cause chronic or long-lasting foot pain. Arthritis from Reiter’s Syndrome can also affect the joints of the back and cause spondylitis, inflammation of the vertebrae in the spinal column. The duration of reactive arthritis symptoms can vary greatly. Most of the literature suggests that the majority of patients recover within a year. The condition, can, however, be permanent. One study found nearly 50% of patients with postdysenteric reactive arthritis continued to have symptoms roughly one year after onset.

The involvement of the eye in Reiter’s Syndrome is most commonly manifested as conjunctivitis, inflammation of the mucous membrane that covers the eyeball, or uveitis, an inflammation of the inner eye. Conjunctivitis and uveitis can cause redness of the eyes, eye pain and irritation, and blurred vision.

The third situs for Reiter’s Syndrome symptoms is the urogenital tract. This includes the prostate, urethra, and penis in men and the fallopian tubes, uterus, and vagina in women. Men may notice an increased need to urinate, a burning sensation when urinating, and a discharge from the penis. Some men also develop prostatitis. Symptoms of prostatitis include fever, chills, increased need to urinate, and a burning sensation when urinating.

1.  J. Buzby. “Older Adults at Risk of Complications from Microbial FoodBorne Illness,” Food Review, Vol. 25, Issue 2, pp. 30-35, at 32, Summer-Fall, 2002.

2.  For more information see www.healthlink.mcw.edu/article/926056398.html.

3.  “Postdysenteric Reactive Arthritis, A Clinical and Immunogenetic Study Following an Outbreak of Salmonellosis.” Inman, Johnston, Hodge, Falk and Helewa. Arthritis and Rheumatism, Vol.31, No. 11, November 1988.