Disseminated gonococcal infection in 21st century: A case report

Abstract

Introduction: Disseminated gonococcal infection (DGI) is an uncommon complication associated with Neisseria gonorrhoeae. But due to early diagnosis and use of newer drugs in gonorrhea, complications like DGI have become a rarity. It is more common in women than men. We herein report a case of this entity occurring in otherwise healthy male who presented with septic shock. Case Report: An 18-year-old healthy male presented with urethral discharge, conjunctivitis, oral ulcerations, and tenosynovitis along with septic shock. History of unprotected sexual contact was present two weeks prior to the onset of above mentioned complaints. A clinical diagnosis of DGI was kept which was confirmed by the presence of gram negative diplococci in urethral and conjunctival discharge smears as well as isolation of gonococci on selective culture media. He responded well to injectable ceftriaxone therapy. Conclusion: The presentation of DGI as septic shock in an immunocompetent male in the absence of predisposing factors is highlighted in this case report. Early diagnosis and treatment is the key to prevent devastating complications like meningitis, endocarditis, perihepatitis, etc. Moreover, infrequent occurrence of DGI calls for the need of introduction of diagnostic criteria in order to facilitate its prompt identification and treatment.