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Disseminated gonococcal infection during pregnancy
Vorapong Phupong1, Tul Sittisomwong, Wirach Wisawasukmongchol
1Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok, 10330, Thailand. vorapong.p@chula.ac.th
Archives of Gynecology and Obstetrics
|September 2, 2005
Summary
Disseminated gonococcal infection (DGI) in pregnancy is rare but can manifest as arthritis. Prompt diagnosis and treatment with antibiotics like ceftriaxone are crucial for positive maternal and neonatal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Rheumatology
Background:
- Disseminated gonococcal infection (DGI) is uncommon in pregnancy, with an incidence of 0.04-0.09%.
- Arthritis is the most frequent clinical presentation of DGI.
Observation:
- A 38-year-old pregnant woman presented with decreased fetal movement, purulent vaginal discharge, fever, and arthritis.
- Joint fluid analysis revealed intracellular Gram-negative diplococci, confirming DGI.
Findings:
- The patient received successful treatment with parenteral ceftriaxone followed by oral cefixime.
- Cesarean section was performed due to preterm premature rupture of membranes; both mother and neonate had uneventful outcomes.
Implications:
- Clinicians should maintain a high index of suspicion for DGI in pregnant patients presenting with arthritic symptoms.
- Early recognition and appropriate antibiotic management are vital for managing DGI during pregnancy.