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Clinical manifestations of disseminated gonococcal infection

  • Preceded by mucosal infection (eg, cervix, urethra, anus, or pharynx) that is → often asx
  • Two distinct syndromes, although Pts can have both:
    • Joint-localized: purulent arthritis (40%), usually 1-2 joints (knees >wrists >ankles)
    • Arthritis-dermatitis syndrome: triad of polyarthralgias, tenosynovitis, skin lesions 1. polyarthralgias: migratory joint pain, can affect small or large joints 2. tenosynovitis: pain/inflammation of tendon and its sheath in wrists, fingers, ankles, toes 3. skin lesions: gunmetal gray pustules with erythematous base on extremities & trunk
  • Rare complications:
    • Fitz-Hugh-Curtis syndrome (perihepatitis),
    • pericarditis
    • meningitis
    • myocarditis
    • osteomyelitis from direct extension of joint-localized infection