REITER'S DISEASE; REPORT OF FIVE CASES INCLUDING TWO SUCCESSFULLY TREATED WITH HYPERTHERMIA

Abstract

The history, symptomatology, complications, and possible etiologic factors in Reiter''s disease are reviewed. Five cases of Reiter''s disease, all chronically ill patients, are reported. Four presented the typical triad of urethritis, conjunctivitis, and arthritis; in 1, conjunctivitis was not present. Two of the 5 cases were treated with a combined hyperthermia-penicillin regimen. Fever of 105[degree] was induced in a hot air cabinet in 5-hr, sessions twice a wk. for a total of 25 hr. For 24 hr. prior to and 25 hr. following fever, penicillin was given in doses of 20,000 U. every two hr. intramusc; during the hyperthermia an additional 100,000 U. was given intraven. in 1,000 ml.of 5% glucose in saline. In both cases so treated response was prompt, and follow-up examinations after 4 and 6 mos. showed no recurrence; this was a marked contrast to the usual course of the disease. The stimulus for the use of the fever-penicillin regimen was the hope that the 2 might exert a synergistic effect similar to that seen with fever and penicillin in neurosyphilis and fever and sulfa drugs in resistant gonorrhea and gonorrheal arthritis. Except for a few favorable reports of the use of foreign protein therapy, there has been no effective therapeutic agent in reducing the morbidity in Reiter''s disease. The important implication from the 2 cases responding favorably here to the fever-penicillin treatment is that this type of therapy may provide a substantial reduction in the morbidity of this naturally protracted disease process.