Diagnóstico clínico y de laboratorio de la artritis gonocócica: a propósito de un caso

Abstract

IntroductionGonococcal arthritis is an uncommon disease in western European countries. Obtaining an early diagnosis is essential to prevent potentially fatal dissemination. A case in the routine work of our laboratory led us to present a short review of the pathophysiology and diagnosis of the disease. Clinical observationA 64 year-old male with, a fever, multiple joint pains, and inflammation in the right ankle. A sample of synovial fluid was obtained by arthrocentesis, with analytical results suggestive of infectious arthritis. This was confirmed by a culture, with the isolation of N. gonorrhoeae, which the antibiogram showed susceptibility to penicillin and ceftriaxone. DiscussionDisseminated N. gonorrhoeae infection includes signs such as, multiple joint pains, tenosynovitis and dermatitis. Certain cases can also present with, single joint arthritis, combined with positive synovial fluid cultures, although with negative blood cultures. The elevated rates of resistance to penicillin and tetracycline require recommending IV ceftriaxone as the treatment of choice. ConclusionGonococcal arthritis can occur in patients without lesions in the genitourinary mucosa. It is commonly associated with negative blood cultures. Only the isolation of the microorganism in synovial fluid enables a definitive diagnosis to be made.