1/14. Disseminated gonococcal infection.The most frequent systemic complication of acute, untreated gonorrhea is disseminated infection, which develops in 0.5 to 3 percent of the more than 700,000 Americans infected with neisseria gonorrhoeae each year. The classic triad of features consists of dermatitis, tenosynovitis and migratory polyarthritis. Disseminated gonococcal infection is most common in young women but may develop in sexually active persons of any age. The diagnosis often is not suspected because the initial mucosal infection is frequently asymptomatic, providing no clue to an infectious etiology. Prompt identification and treatment are essential to prevent complications such as endocarditis, meningitis, perihepatitis and permanent joint damage.- - - - - - - - - - ranking = 1keywords = gonorrhoeae (Clic here for more details about this article) |
2/14. Gonococcal septic arthritis of the hip.We describe a patient with a neisseria gonorrhoeae monoarthritis of the hip. Treatment with intravenous ceftriaxone, oral doxycycline, and repeated fluoroscopic needle aspirations resulted in a complete recovery of function without residual deficit. Gonococcal monoarthritis of the hip is rare. Gonococcal hip infections appear to respond well to antibiotics and drainage by arthrocentesis. This differs from hip infections caused by other bacteria where joint damage is common and where the recommended initial treatment is open surgical drainage.- - - - - - - - - - ranking = 1keywords = gonorrhoeae (Clic here for more details about this article) |
3/14. Increased risk of neisserial infections in systemic lupus erythematosus.survival in systemic lupus erythamatosus (SLE) continues to improve because of better ancillary care, earlier diagnosis, and earlier treatment. However, infection remains a leading cause of morbidity and mortality in this disease. Although corticosteroids and immunosuppresives increase the risk of opportunistic infection, the SLE patient is still most at risk from common bacterial pathogens. As the prototypic immune-complex disease, patients with active SLE have low circulating complement as well as a reticuloendothelial system (RES) saturated with immune complexes. It seems intuitive that SLE patients should be most at risk for organisms dependent for their removal on the RES or complement for opsonization or bacteriolysis. The current series presents four patients with SLE and disseminated neisseria infection and brings to 14 the number of patients in the literature with disseminated neisserial infection. They are typically young, female, with renal disease, and either congenital or acquired hypocomplementemia, and may present with all features of a lupus flare. Surprisingly, they are not all on corticosteroids or immunosuppressives and have some features that are unusual for non-SLE patients with these infections. There seems to be an over-representation of Nisseria meningitidis (despite potential reporting bias), and there ironically may be better tolerance with fewer fulminant complications in patients who have complement deficiencies. The best approach for the physician treating SLE is to immunize all SLE patients with available bacterial vaccines to N meningitidis and streptococcus pneumonia, have a low threshold of suspicion for the diagnosis of disseminated neisserial or other encapsulated bacterial infection in the SLE patient who is sick, and to treat empirically with third generation cephalosporins after appropriate cultures.- - - - - - - - - - ranking = 1.4834633752378keywords = neisseria (Clic here for more details about this article) |
4/14. Gonococcal arthritis complicated by acute pericarditis and pericardial effusion.A woman of 23 presented with a painful, swollen left knee. A thick yellow fluid aspirated from the joint cavity grew neisseria gonorrhoeae. Central pleuritic chest pain and ST segment elevation developed 48 hours after presentation. These signs and symptoms of pericarditis had settled two months after the acute illness.- - - - - - - - - - ranking = 1keywords = gonorrhoeae (Clic here for more details about this article) |
5/14. Gonococcal arthritis caused by auxotype P in a man with hiv infection.The development of gonococcal arthritis is reported in a man with hiv infection and CDC Stage IVC2 disease. The diagnosis of disseminated neisseria gonorrhoeae was facilitated by microbiological examination of a joint aspirate. The auxotype identified by culture was moderately resistant to penicillin, a characteristic which is highly unusual for an organism causing disseminated gonococcal infection. This case serves as an example of the role of hiv infection in the modification of host response to common pathogens and the need for clinicians to modify their management of disseminated gonococcal infection especially in immunosuppressed persons.- - - - - - - - - - ranking = 1keywords = gonorrhoeae (Clic here for more details about this article) |
6/14. Mixed gonococcal and mycobacterial sepsis of the wrist.Mycobacterial infections of the hand and wrist are rare. Concurrent infection of a joint by more than one organism is also unusual. A 25-year-old man developed wrist sepsis caused by neisseria gonorrhoeae and mycobacterium avium intracellularis. The infection was successfully treated by wrist drainage, carpal debridement, and intravenous antibiotics. Secondary carpal reconstruction was accomplished by delayed bone grafting and internal fixation to preserve radiocarpal motion.- - - - - - - - - - ranking = 1keywords = gonorrhoeae (Clic here for more details about this article) |
7/14. Disseminated neisserial infection in pregnancy: the empress may have a change of clothing.A case of disseminated neisserial disease during pregnancy with good perinatal outcome is presented along with two examples of disseminated N. meningitidis from endocervical site. Upon close review, it is clear that the biological similarities of both N. gonorrhoeae and N. meningitidis may outweigh their differences. The two organisms may behave in clinically indistinguishable fashion and probably justify a more cautious approach to the clinical syndromes we have considered the inviolate domain of the gonococcus. The management of disseminated neisserial disease in pregnancy should include prompt empiric parenteral therapy while aggressive diagnostic confirmation of the organism is pursued. In addition, neonatal conjunctivitis caused by a Gram-negative diplococci should be treated parenterally until clinical response and identity of the organism is confirmed.- - - - - - - - - - ranking = 2.2715400359181keywords = gonorrhoeae, neisseria (Clic here for more details about this article) |
8/14. The acute arthritis-dermatitis syndrome. The changing importance of neisseria gonorrhoeae and neisseria meningitidis.Sexually active young adults with an acute arthralgia or arthritis, with or without associated skin lesions, often have disseminated gonococcal infection (DGI). In recent years, an increasing proportion of patients seen with such complaints at the University of washington hospitals, Seattle, have had systemic meningococcal infection rather than DGI. Among 151 patients with acute arthritis studied prospectively from 1970 to 1972, blood or synovial fluid cultures yielded neisseria gonorrhoeae in 30 patients and neisseria meningitidis in two. Among 62 patients meeting the same criteria who were studied prospectively from 1980 to 1983, blood or synovial fluid cultures yielded gonococci in nine and meningococci in five. Separate analysis of blood culture results from two University of washington hospitals also revealed a decline in the number of cases of gonococcemia from 1970 through 1984 and a shift in the relative numbers of patients with bacteremia due to N gonorrhoeae and N meningitidis. The observed decline in gonococcemia coincides with a decline in the proportion of gonorrhea in Seattle caused by gonococcal strains that have been associated with DGI.- - - - - - - - - - ranking = 6keywords = gonorrhoeae (Clic here for more details about this article) |
9/14. Septic arthritis after ureteroneocystostomy.Acute infectious arthritis is an uncommon disease that is most commonly caused by neisseria gonorrhoeae or gram-positive cocci. gram-negative bacteria are an infrequent and highly virulent cause of septic arthritis and most commonly enter the circulation through the urinary tract, as in this case after ureteroneocystostomy. The resulting arthritis carries a mortality of 25% and a morbidity of 80%. Early recognition and treatment with appropriate antibiotics and mechanical drainage is imperative. Needle drainage of the affected joint has been shown superior to open surgical drainage.- - - - - - - - - - ranking = 1keywords = gonorrhoeae (Clic here for more details about this article) |
10/14. Aseptic arthritis after gonorrhoea.Sixteen patients with aseptic arthritis developing after gonorrhoea and 14 patients with arthritis after nongonococcal urogenital infection have been analysed with respect to clinical course, roentgenological signs, and humoral as well as cellular immune responses to neisseria gonorrhoeae antigen. Fifty-eight healthy blood donors were used as controls. The clinical pattern did not differ significantly between the 2 groups. eye or skin lesions indicative of Reiter's syndrome were found in 5 patients of both groups. Signs of sacroiliac arthritis were found in 8 and 6 patients respectively. Gonococcal complement fixation was positive in 9 of 16 patients in the postgonorrhoeal arthritis group and in 0 of 14 patients in the arthritis group with nongonococcal urogenital infection. The lymphocyte stimulation induced by gonococcal antigen was significantly greater in patients with postgonorrhoeal arthritis than in healthy controls. When reference was made to the results of stimulation of the lymphocytes with PPD, there was also a significant difference in the lymphocyte reactivity to gonococcal antigen between the group of patients with postgonorrhoeal arthritis and that of patients with arthritis after non-gonococcal urogenital infection. No such difference was noted between the latter group and the healthy controls. The clinical and immunologic data argue in favour of the hypothesis that neisseria gonorrhoeae may induce an aseptic arthritis which sometimes presents as a complete Reiter's syndrome.- - - - - - - - - - ranking = 2keywords = gonorrhoeae (Clic here for more details about this article) |
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