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[Arthritis without urethritis: remember gonococcus].

J-P Le Berre1, J Samy, E Garrabé

  • 1Service de Rhumatologie, Hôpital d'Instruction des Armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France. mjpleberre@cfibre.fr

La Revue De Medecine Interne
|December 15, 2006
PubMed
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Gonococcal arthritis, a cause of septic arthritis in adults, can occur without urethritis. Early treatment with advanced-generation cephalosporins is crucial for a full recovery.

Area of Science:

  • Infectious Diseases
  • Rheumatology
  • Microbiology

Background:

  • Septic arthritis caused by Neisseria gonorrhoeae is a significant concern in sexually active adults.
  • It often presents as monoarticular or pauciarticular joint inflammation.
  • Clinical suspicion is warranted even when urethritis symptoms are absent.

Observation:

  • This case report details a young male patient diagnosed with gonococcal arthritis.
  • The patient presented without symptoms of urethritis.
  • Diagnostic findings included positive synovial fluid cultures and negative blood cultures.

Findings:

  • Neisseria gonorrhoeae was identified as the causative agent of septic arthritis.
  • The absence of urethritis highlights a less common presentation of gonococcal arthritis.

Related Experiment Videos

  • Penicillin-resistant strains were identified, indicating evolving resistance patterns.

    • Implications:

    • Prompt diagnosis and treatment of gonococcal arthritis lead to complete recovery without lasting effects.
    • The prevalence of penicillin resistance necessitates the use of advanced-generation cephalosporins as first-line therapy.
    • This case underscores the importance of considering gonococcal arthritis in the differential diagnosis of joint pain in sexually active individuals.