Answer 5 Azithromycin. This patient has the classic triad of arthritis, nongonococcal urethritis, and conjunctivitis specific to reactive arthritis associated with Chlamydia trachomatis infection (formerly known as Reiter syndrome). The arthritis is an asymmetric oligoarthritis, predominantly of the lower extremity. The treatment of urethritis with antibiotics has not been shown to modify the course of the disease but is needed to eradicate infection with C. trachomatis in this case. Most patients have a self-limited course of arthritis and need only symptomatic treatment with nonsteroidal anti-inflammatory drugs. Azithromycin and doxycycline are the best agents to cover C. trachomatis. Acyclovir, penicillin, and ceftriaxone are indicated for treatment of herpes, syphilis, and gonorrhea, respectively. Click here to return to the questions
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