Dr. Naval Mendiratta
Rheumatology
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Patient's Query
Hi doctor,
I had unprotected sex two months back and developed a Streptococcal infection within a day. I took Amoxicillin to get rid of it. Within five days developed a yeast infection and got treatment for that. Now, I have reactive arthritis. I got two painless red bumps on the back of my hand and I do not know whether it is related to reactive arthritis. My urine sample was negative for chlamydia. But, the doctor found gram-positive Staphylococcus and said it was normal. He suggested Loxonin which is a NSAID. Is Staphylococcus infection dangerous? I had CBC and got the result as monocytes and CRP were elevated. In a gap of two weeks, time repeated CBC again and everything was normal. Now, the urine test came out as gram-positive. I am suffering from multiple joint inflammation, lightheaded, fatigue, upper respiratory difficulties, papules, conjunctivitis, and gram-positive Staphylococcus. What is the solution?
Hi,
Welcome to icliniq.com
Could you give me the exact duration of the disease? Which are the joints involved in your case? For reactive arthritis (a painful form of inflammatory arthritis), you do not need much treatment. It normally subsides by itself. NSAIDs (nonsteroidal anti-inflammatory drugs) and short courses of steroids are usually helpful. But, if it persists for more than six weeks then one needs to add Sulfasalazine. Make sure you get HLA-B27 (human leukocyte antigen) done. It will help to determine whether the disease will relapse or going to be prolonged.
Thank you.
Patient's Query
Hi doctor,
I believe it was a month before I started feeling the symptoms. It started in my right knee then moved to my left hip and then right hip. The back of my legs was the worst and I could not move. I am a softball player and a pitcher. The symptoms are getting better though. I am not as sore as I was before. Although I am having pains near my left rib cage, it is warm when I touch the spot. I do see a difference in the symptoms. I have been exercising and stretching a lot along with trying to stay hydrated. There should not be anything to worry about right? I have red lesions on my forearm and some on my hand. I do not have clusters of them. Altogether I have five. Please help.
Hi,
Welcome back to icliniq.com.
Well, those lesions can be keratoderma blennorrhagicum (thickened skin lesion with mucous discharge) which is a common finding in reactive arthritis. It tends to fade away over time. It is usually seen on the palms and soles. Probably the unprotected sex triggered reactive arthritis. It is very difficult to isolate the organism in urine. But nevertheless, complete a course of antibiotics like Doxycycline for five to seven days. As for arthritis, NSAIDs are the safest. Since you say it is already improving, you do not need much of treatment at this stage. But, do get HLA-B27 done. It will help us to know if there can be a relapse. Avoid eating uncooked food outside, as diarrhea can be another trigger for arthritis. Do not worry about Staphylococcus. It can be a commensal that is just incidentally found. If you had Staphylococcus aureus then you would be more sick than this. So, I do not think you need antibiotics for it. As of now, be mobile and continue Loxonin (Loxoprofen) as and when needed and get the test done.
Thank you.
The Probable causes
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Rheumatology
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