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Gonococcemia (also known as "Disseminated gonococcal infection" [1]) is a rare complication of mucosal Neisseria gonorrhoeae infection, or Gonorrhea, that occurs when the bacteria invade the bloodstream. [2] It is characterized by fever, tender hemorrhagic pustules on the extremities or the trunk, migratory polyarthritis, and tenosynovitis. [3]
It causes the sexually transmitted genitourinary infection gonorrhea [6] as well as other forms of gonococcal disease including disseminated gonococcemia, septic arthritis, and gonococcal ophthalmia neonatorum. N. gonorrhoeae is oxidase positive and a microaerophile that is capable of surviving phagocytosis and growing inside neutrophils. [6]
In patients who may have disseminated gonococcal infection (DGI), all possible mucosal sites should be cultured (e.g., pharynx, cervix, urethra, rectum). [42] Three sets of blood cultures should also be obtained. [43] Synovial fluid should be collected in cases of septic arthritis. [42]
Gonococcal arthritis – Neisseria gonorrhoeae is a common cause of septic arthritis in people who are sexually active and under 40 years old. [2] [11] The bacteria is spread through the blood to the joint following sexual transmission. Other symptoms of disseminated gonococcal infection can include migration of joint pain, tenosynovitis and ...
Fitz-Hugh–Curtis syndrome occurs almost exclusively in women, though it can be seen in males rarely. [5] It is complication of pelvic inflammatory disease (PID) caused by Chlamydia trachomatis (Chlamydia) or Neisseria gonorrhoeae (Gonorrhea) though other bacteria such as Bacteroides, Gardnerella, E. coli and Streptococcus have also been found to cause Fitz-Hugh–Curtis syndrome on occasion. [6]
Reactive arthritis, previously known as Reiter's syndrome, [1] is a form of inflammatory arthritis [2] that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease. [ 3 ]
Gonococcal arthritis (a bacterial arthritis) is also initially migratory and can involve tendons around the wrists and ankles. Sometimes arthritis is in an undifferentiated stage (i.e. none of the above criteria is positive), even if synovitis is witnessed and assessed with ultrasound imaging.
Antimicrobials are generally the drug of choice for gonococcal and non-gonococcal infections. The CDC in 2015 suggests using a dual therapy that consists of two antimicrobials that have different mechanisms of action would be an effective treatment strategy for urethritis and it could also potentially slow down antibiotic resistance. [22]