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Ten Years of Disseminated Gonococcal Infections in North Carolina: a Review of Cases from a Large Tertiary Care Hospital
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7 01 2023
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Source: Sex Transm Dis. 50(7):410-414
[PDF-148.23 KB]
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Alternative Title:Sex Transm Dis
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Description:Background:
The detection and reporting of disseminated gonococcal infection (DGI) has been increasing across the United States (US).
Methods:
We conducted a retrospective chart review of DGI case-patients diagnosed between 2010 and 2019 at a large tertiary care hospital in North Carolina.
Results:
We identified 12 DGI case-patients (7 males and 5 females, aged 20 to 44 years old) of whom 5 had Neisseria gonorrheae isolated from a sterile site (confirmed), 2 had N. gonorrheae detected at a non-sterile mucosal site and had clinical manifestations consistent with DGI (probable), and 5 did not have N. gonorrheae isolated from any site, but DGI was the most likely diagnosis (suspect). Among the 12 DGI case-patients, the most common manifestation was arthritis or tenosynovitis (n=11); one patient had endocarditis. Half of the patients had significant underlying co-morbidities or predisposing factors, including complement deficiency. Eleven of the 12 case-patients were hospitalized, and 4 required surgical intervention.
Conclusions:
This case series highlights the difficulty of making a definitive diagnosis of DGI, which could negatively affect reporting to public health authorities and hinder surveillance efforts to determine the true prevalence of DGI. A high index of suspicion is required and a full diagnostic work-up should be pursued in all cases of suspected DGI.
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Pubmed ID:36877637
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Pubmed Central ID:PMC10286694
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Volume:50
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Issue:7
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