1/45. Disseminated gonococcal infection during pregnancy.BACKGROUND: Disseminated gonococcal infection in pregnancy is rare with the incidence of 0.04-0.09% in pregnant women. Its most common manifestation is arthritis. CASE: A 38-year-old woman, G1P0, 36 weeks pregnancy came to hospital with decreased fetal movement. She had purulent vaginal discharge and history of self treatment 1 month earlier. She had a fever with arthritis for 3 days. Purulent joint fluid from arthrocentesis of her right wrist demonstrated intracellular Gram negative diplococcal bacteria. The diagnosis was disseminated gonococcal infection. She was successfully treated with parenteral ceftriaxone followed by oral cefixime. cesarean section was performed due to preterm premature rupture of the membranes. The maternal and neonatal outcomes were uneventful. CONCLUSION: Disseminated gonococcal infections are not rare, however, disseminated gonococcal infection in pregnancy is a rare condition. Clinicians should be suspicious of the disease when a pregnant patient presents with arthritic symptoms.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
2/45. Disseminated gonococcal infection in pregnancy presenting as meningitis and dermatitis.BACKGROUND: In 2003, the reported gonorrhea rate among women was 118.8 per 100,000 women. Most gonococcal infections in pregnant women are asymptomatic or produce a mildly symptomatic genital infection. Disseminated infections can occur when gonococcal bacteremia produces extragenital symptoms, most commonly arthritis. CASE: A patient presented in the third trimester of pregnancy with fever, body aches, neck soreness, and skin lesions. There was no arthritis. Cultures performed during evaluation confirmed extragenital neisseria gonorrhoeae. CONCLUSION: A high index of suspicion is necessary to diagnose disseminated gonococcal infection and prevent disease sequelae.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
3/45. Disseminated gonococcal infection.The most frequent systemic complication of acute, untreated gonorrhea is disseminated infection, which develops in 0.5 to 3 percent of the more than 700,000 Americans infected with neisseria gonorrhoeae each year. The classic triad of features consists of dermatitis, tenosynovitis and migratory polyarthritis. Disseminated gonococcal infection is most common in young women but may develop in sexually active persons of any age. The diagnosis often is not suspected because the initial mucosal infection is frequently asymptomatic, providing no clue to an infectious etiology. Prompt identification and treatment are essential to prevent complications such as endocarditis, meningitis, perihepatitis and permanent joint damage.- - - - - - - - - - ranking = 0.5keywords = arthritis (Clic here for more details about this article) |
4/45. Gonococcal septic arthritis of the hip.We describe a patient with a neisseria gonorrhoeae monoarthritis of the hip. Treatment with intravenous ceftriaxone, oral doxycycline, and repeated fluoroscopic needle aspirations resulted in a complete recovery of function without residual deficit. Gonococcal monoarthritis of the hip is rare. Gonococcal hip infections appear to respond well to antibiotics and drainage by arthrocentesis. This differs from hip infections caused by other bacteria where joint damage is common and where the recommended initial treatment is open surgical drainage.- - - - - - - - - - ranking = 3keywords = arthritis (Clic here for more details about this article) |
5/45. An unusual presentation of gonococcal arthritis in an hiv positive patient.A 27 year old, hiv positive, homosexual man was admitted for evaluation and treatment of acute oligoarticular arthritis. Gonococcal arthritis was found in a single hip and a single sternoclavicular joint, which is an unusual distribution for this bacterial pathogen.- - - - - - - - - - ranking = 3keywords = arthritis (Clic here for more details about this article) |
6/45. Chronic meningococcal disease.Chronic meningococcal septicaemia is an unusual and infrequently recognised presentation of disease caused by neisseria meningitidis. Clinical features are immunologically mediated and include fever, rash and arthritis, which may mimic cutaneous vasculitis or reactive gonococcal arthritis. diagnosis is difficult to confirm as blood cultures commonly do not grow the organism despite weeks of symptoms. culture of the organism from the nasopharynx may provide supportive evidence for diagnosis. Chronic meningococcaemia should be considered in the differential diagnosis of a cutaneous vasculitis. In the clinical setting of an undiagnosed fever with vasculitic rash and joint symptoms an empirical trial of intravenously administered penicillin should be considered before steroid therapy as a rapid response may simplify the diagnostic dilemma.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
7/45. Gonococcal arthritis complicated by acute pericarditis and pericardial effusion.A woman of 23 presented with a painful, swollen left knee. A thick yellow fluid aspirated from the joint cavity grew neisseria gonorrhoeae. Central pleuritic chest pain and ST segment elevation developed 48 hours after presentation. These signs and symptoms of pericarditis had settled two months after the acute illness.- - - - - - - - - - ranking = 2keywords = arthritis (Clic here for more details about this article) |
8/45. Gonococcal arthritis caused by auxotype P in a man with hiv infection.The development of gonococcal arthritis is reported in a man with hiv infection and CDC Stage IVC2 disease. The diagnosis of disseminated neisseria gonorrhoeae was facilitated by microbiological examination of a joint aspirate. The auxotype identified by culture was moderately resistant to penicillin, a characteristic which is highly unusual for an organism causing disseminated gonococcal infection. This case serves as an example of the role of hiv infection in the modification of host response to common pathogens and the need for clinicians to modify their management of disseminated gonococcal infection especially in immunosuppressed persons.- - - - - - - - - - ranking = 2.5keywords = arthritis (Clic here for more details about this article) |
9/45. Gonococcal pericarditis with tamponade in a patient with systemic lupus erythematosus.pericarditis is one of the most frequent manifestations of systemic lupus erythematosus; however, purulent pericarditis and tamponade are rare. We describe a patient with systemic lupus erythematosus and culture-proven gonococcal arthritis who developed purulent pericarditis with intracellular gram-negative diplococci. Evidence of tamponade was seen on echocardiography. There has not been a reported case of neisseria gonorrhoeae in pericardial fluid or tissue since the introduction of antibiotics.- - - - - - - - - - ranking = 0.5keywords = arthritis (Clic here for more details about this article) |
10/45. Monarthric gonococcal arthritis involving the calcaneocuboid joint.Gonococcal arthritis is a frequently occurring clinical entity that should be included routinely in a differential diagnosis of pedal joint pain. Unfortunately, the lack of specificity in the presentation makes gonococcal arthritis difficult to diagnose. Indices of suspicion should rise with any sexually active patient, particularly when septic arthritis is suspected without a detectable portal of entry. The authors emphasize again the importance of carefully choosing empiric antibiotic coverage for gonococcal arthritis. Three factors that should be considered are regional epidemiology, the anatomical site of the primary infection, and the possible coexistence of other infectious agents. Understanding the clinical staging of this condition will help to achieve a timely diagnosis and successful treatment.- - - - - - - - - - ranking = 4keywords = arthritis (Clic here for more details about this article) |
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