Meningococcal arthritis simulating gonococcemia

A 19-year-old man was admitted to the hospital with acute onset of fever, sore thoart, and leg pain. He gave a history of recent sexual activity and was found to have an exudative pharyngitis, two pustular skin lesions, and a hot, swollen left knee. Laboratory studies were consistent with an acute septic arthritis and the diagnosis of the gonococcal arthritis-dermatitis syndrome was entertained. He responded to high doses of penicillin, and Neisseria meningitidis, group B, subsequently was cultured from the blood and pharynx. The same organism was isolated from the throats of three of 11 asymptomatic contacts.