Disseminated Gonococcal Infection

August 14 19:59 2019 Print This Article

Disseminated Gonococcal Infection is a systemic infection that follows the hematogenous dissemination of the gonococcus from infected mucosal sites to skin, tenosynovium, and joints and is characterized by fever, petechial or pustular acral lesions, asymmetric arthralgias, tenosynovitis, or septic arthritis. It is occasionally complicated by perihepatitis and, rarely, endocarditis or meningitis. Disseminated gonococcal infection (DGI) occurs in 0.5 to 3 percent of patients infected with Neisseria gonorrhoeae.

The majority of patients with DGI have arthritis or arthralgia as one of their principle manifestations. Most are younger than 40 years of age, although DGI can occur in virtually any age group including rare cases in the elderly. In the preantibiotic era, gonococcal arthritis was a well recognized illness in newborns. DGI is a common cause of acute polyarthralgias, polyarthritis, or oligoarthritis in young, healthy patients.

Males or females may be affected. As an example, one study of 151 consecutive patients with acute nontraumatic arthritis or arthralgia seen at the University of Washington hospitals found that N. gonorrhoeae was the most common cause of illness. DGI has a number of unique and characteristic clinical features that allow it to be distinguished from other types of infectious arthritis.

Causes of Disseminated Gonococcal Infection

This infection occurs in people who have been infected with gonorrhea. It affects women four times more often than men, and is most common among active adolescent girls. There is also increased risk during menstruation and pregnancy. Two forms of arthritis exist one with skin rashes and multiple joint involvement, and a second, less common, form in which disseminated gonococcemia leads to infection of a single joint (monoarticular) and joint fluid cultures are positive.

Signs and Symptoms of Disseminated Gonococcal Infection

Sign and symptoms may include the following:

  • Fever
  • Skin infection ( cellulitis)
  • pink to red
  • Chills, malaise
  • Skin rash or lesion
  • Joint swelling (knees, wrists, ankles)