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[Purulent peritonitis due to gonococcal infection]
Merle A J Geerds1,2, Laurens Jan van Driel1, Thera A M Trienekens3
1VieCuri Medisch Centrum, afd. Algemene Chirurgie, Venlo.
Nederlands Tijdschrift Voor Geneeskunde
|October 25, 2019
Summary
A rare case of Neisseria gonorrhoeae caused terminal ileitis and peritonitis in a woman. Prompt antibiotic treatment led to recovery, highlighting extragenital infection possibilities.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Gynecology
Background:
- Neisseria gonorrhoeae is a common sexually transmitted bacterium.
- Gonococcal infections can manifest urogenitally and extragenitally.
- Extragenital presentations require careful diagnostic consideration.
Observation:
- A 55-year-old woman presented with malaise, abdominal pain, and fever.
- Initial investigations failed to identify a cause for her symptoms.
- She developed peritonitis and rising infection markers during hospitalization.
Findings:
- Diagnostic laparoscopy revealed terminal ileitis and purulent peritonitis.
- PCR of abdominal exudate was positive for Neisseria gonorrhoeae.
- Bacterial cultures of the exudate were negative.
- Intravenous ceftriaxone treatment for 8 days resulted in symptom resolution.
Implications:
- Terminal ileitis with peritonitis is an uncommon extragenital manifestation of gonococcal infection.
- Diagnosis may necessitate surgical exploration and targeted testing.
- Highlights the importance of considering Neisseria gonorrhoeae in unexplained abdominal sepsis.
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