Disseminated gonococcal infection during pregnancy

Disseminated gonococcal infection in pregnancy is rare with the incidence of 0.04-0.09% in pregnant women. Its most common manifestation is arthritis.

A 38-year-old woman, G1P0, 36+ weeks pregnancy came to hospital with decreased fetal movement. She had purulent vaginal discharge and history of self treatment 1 month earlier. She had a fever with arthritis for 3 days. Purulent joint fluid from arthrocentesis of her right wrist demonstrated intracellular Gram negative diplococcal bacteria. The diagnosis was disseminated gonococcal infection. She was successfully treated with parenteral ceftriaxone followed by oral cefixime. Cesarean section was performed due to preterm premature rupture of the membranes. The maternal and neonatal outcomes were uneventful.

Disseminated gonococcal infections are not rare, however, disseminated gonococcal infection in pregnancy is a rare condition. Clinicians should be suspicious of the disease when a pregnant patient presents with arthritic symptoms.