Diagnosis of disseminated gonorrhea

The Bottom Line: Gonococcal arthritis results from infection of N. gonorrhoeae acquired from primary sexually transmitted mucosal infection. Mucosal surfaces such as the urethra, endocervix, pharynx, rectum and cervico-vaginal mucosa may be infected by the gonococci . In a minority of patients, especially in those untreated, the infection can progress to induce endometriosis, salpingitis, prostatitis, dermatitis, arthritis and DGI.

García Arias, Miriam Septic arthritis. Baillière’s best practice & research. Clinical rheumatology 2011 vol:25 iss:3 pg:407 -421

In approximately 42–85% of DGI patients, gonococcal arthritis develops. During the 70s, Gonococcal infection accounted for approximately 2/3 of the cases of septic arthritis and tenosynovitis in North America. The incidence has decreased primarily due to the implementation of effective control programs. Females have four times greater risk of developing gonococcal arthritis. This can be attributed to the delay in diagnosis because of the asymptomatic nature of gonococcal infections in women. Because clearance of a gonococcal infection depends on an effective complement-mediated immune response, a complement deficiency, particularly in the terminal components (C5–C8) , is a risk factor for developing gonococcal arthritis.

jkn 2/16

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