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Gonococcal Peritonitis Complicated by Intraperitoneal Abscess and Pleural Empyema: A Case Report
Hanne Rheder Ellegaard Mikkelsen1,2, Filip Lyng Lindgren3, Thomas Vemmelund Rose4
1Department of Clinical Microbiology Aalborg University Hospital Aalborg Denmark.
Clinical Case Reports
|July 22, 2026
Summary
This case report details a rare instance of gonococcal peritonitis in a woman with liver cirrhosis, complicated by abscess and effusion. Successful management involved drainage and targeted antibiotics, highlighting a unique clinical presentation.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Gastroenterology
Background:
- Gonococcal peritonitis is a rare complication of Neisseria gonorrhoeae infection.
- Liver cirrhosis can predispose individuals to various infections, including intra-abdominal infections.
- Intraperitoneal abscess and pleural effusion are uncommon but serious complications.
Purpose of the Study:
- To report a unique case of gonococcal peritonitis.
- To describe the clinical presentation and management of this rare condition.
- To highlight challenges in identifying the source of infection.
Main Methods:
- Case presentation of a 52-year-old woman with liver cirrhosis.
- Diagnostic workup including imaging and microbiological cultures.
- Management involved repeated drainage procedures and antimicrobial therapy.
Main Results:
- The patient presented with gonococcal peritonitis, an intraperitoneal abscess, and pleural effusion.
- No evidence of a confirmed genital infection was found.
- The infection was successfully treated with drainage and 6 weeks of targeted antibiotics.
Conclusions:
- Gonococcal peritonitis can occur without a clear genital source, particularly in patients with underlying liver disease.
- Multidisciplinary management including surgical drainage and appropriate antibiotic therapy is crucial.
- This case underscores the importance of considering atypical presentations of common infections in complex patients.
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