Gonococcal arthritis (disseminated gonococcal infection)

Area of Science:

• Infectious Diseases
• Rheumatology
• Microbiology

Background:

• Neisseria gonorrhoeae can cause septic arthritis, often presenting as monoarticular or pauciarticular inflammation.
• Gonococcal bacteremia is frequently associated with polyarthralgias and characteristic skin lesions.
• Disseminated gonococcal infection (DGI) diagnosis is supported by documented mucosal infection and clinical response to antibiotics.

Purpose of the Study:

• To outline the clinical presentation and diagnostic criteria for gonococcal arthritis and DGI.
• To provide guidance on appropriate initial hospitalization and antimicrobial therapy for gonococcal arthritis and DGI.

Main Methods:

• Review of clinical presentations differentiating septic arthritis from bacteremic forms of DGI.
• Analysis of diagnostic indicators including synovial fluid and blood cultures, and mucosal infection confirmation.
• Evaluation of recommended antimicrobial treatment regimens.

Main Results:

• Septic arthritis from N. gonorrhoeae typically shows positive synovial fluid cultures and negative blood cultures.
• Gonococcal bacteremia is linked to widespread joint pain and skin manifestations.
• Successful treatment relies on prompt antimicrobial therapy, often starting with ceftriaxone.

Conclusions:

• Hospitalization is recommended for suppurative arthritis or diagnostic uncertainty in suspected DGI.
• Initial management involves advanced-generation cephalosporins, with subsequent treatment completed using fluoroquinolones for a total of one week.