Gonococcal arthritis with systemic involvement: A case report

Abstract

Abstract: INTRODUCTION Septic arthritis caused by N. gonorrhoeae is rare in our setting. Systemic dissemination may present as a characteristic triad of skin rash, tenosynovitis and arthritis. CASE PRESENTATION A 47-year-old man, previously healthy, had oligoarticular pain for seven days. He developed polyarthralgia and skin lesions. Arthrocentesis, blood cultures and laboratory tests with a rheumatological profile were performed. Antibiotic treatment was started and subsequent arthroscopic debridement of the knee was performed after synovial fluid and laboratory analysis. Blood cultures revealed N. gonorrhoeae . The patient complied with antibiotic treatment and evolved favorably until he recovered completely. DISCUSSION N. Gonorrhoeae has a low systemic dissemination. Joint involvement may resolve spontaneously. Tenosynovitis affects more the dorsum of the hands and wrists. The skin lesions are purplish macules that may develop into vesicles or pustules. There may be immunological lesions. Cultures are often negative. Other pathologies with joint and skin involvement should be known, such as systemic lupus erythematosus, psoriatic arthritis and reactive arthritis. Treatment consists of surgical debridement and antibiotics. In contrast to other septic arthritis, complications are rare and the prognosis is good.