Acute septic elbow monoarthritis with associated neisseria gonorrhoeae bacteraemia: An uncommon presentation of an old disease

Michael J. Piazza, Jose A. Gonzales-Zamora

Research output: Contribution to journalArticlepeer-review

Abstract

Neisseria gonorrhoeae is an uncommon present-day cause of septic arthritis. It is generally seen in the younger patient population and is often difficult to isolate in the lab. Blood cultures performed as routine work are usually negative, and when positive tend to be seen in the classic form of disseminated gonococcal infection. Here we report a case of acute septic mon-oarthritis, associated with N. gonorrhoea bacteraemia, in a 67-year-old male patient with multiple chronic co-morbidities, who presented with acute pain and swell-ing at his left elbow, and no associated skin changes. Arthrocentesis findings were consistent with septic arthritis. Blood cultures drawn on admission grew N. gonorrhoeae. Synovial fluid culture was sterile but did exhibit Gram-negative cocci on Gram stain. The pa-tient was started on IV antibiotics, and later underwent incision and drainage with subsequent improvement in symptoms. We thus present an unusual form of disseminated gono-coccal infection in the setting of: epidemiology, physi-cal presentation, as well as microbiologic findings. Al-though less common, DGI should be considered in the differential for septic join in the older adult population, and a sexual history should be obtained in all patients. This patient ultimately had an excellent outcome given his prompt presentation after symptom onset and im-mediate initiation of medical therapy.

Original languageEnglish (US)
Pages (from-to)253-257
Number of pages5
JournalInfezioni in Medicina
Volume28
Issue number2
StatePublished - 2020

Keywords

  • Disseminated gonococcal infection
  • Gonococcal arthritis
  • Neisseria gonorrhoeae
  • Septic arthritis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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