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Disseminated gonococcal infection involving the foot
1Department of Podiatric Surgery, Straith Memorial Hospital, Southfield, Michigan.
The Journal of Foot Surgery
|September 1, 1989
Summary
Disseminated gonococcal infection (DGI) can present with varied symptoms like pharyngitis and joint pain. Prompt diagnosis and antibiotic treatment are crucial for effective management of Neisseria gonorrhoeae.
Area of Science:
- Infectious Diseases
- Rheumatology
- Microbiology
Background:
- Neisseria gonorrhoeae is a significant cause of sexually transmitted infections.
- Penicillin resistance in N. gonorrhoeae is a growing global health concern.
- Disseminated gonococcal infection (DGI) can manifest with diverse clinical presentations.
Observation:
- A patient presented with pharyngitis and initially denied urogenital inflammation, delaying diagnosis.
- Initial treatment with oral penicillin for pharyngitis was ineffective due to penicillin-resistant strains.
- The patient developed migratory polyarthralgia and acute arthritis, indicative of DGI.
Findings:
- The patient's symptoms were attributed to a penicillin-resistant Neisseria gonorrhoeae infection.
- Delayed diagnosis and ineffective initial treatment complicated the clinical course.
- Rapid and complete resolution of symptoms was achieved upon appropriate antibiotic administration.
Implications:
- Highlights the importance of considering DGI in patients with pharyngitis and joint pain, even with absent or denied urogenital symptoms.
- Underscores the clinical challenge posed by antibiotic-resistant Neisseria gonorrhoeae strains.
- Emphasizes the need for timely and accurate diagnosis and appropriate antibiotic selection for successful DGI management.