Ten Years of Disseminated Gonococcal Infections in North Carolina: a Review of Cases from a Large Tertiary Care Hospital

Details

• Alternative Title:
  Sex Transm Dis
• Personal Author:
  Sciaudone, Michael ; Cope, Anna ; Mobley, Victoria ; Samoff, Erika ; Seña, Arlene C.
• 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.
  
  
• Subjects:
  Female Gonorrhea Humans Male Neisseria Gonorrhoeae North Carolina Retrospective Studies Tertiary Care Centers
• Keywords:
  Disseminated Gonococcal Infection Gonorrhea Sexually Transmitted Diseases Surveillance
• Source:
  Sex Transm Dis. 50(7):410-414
• Pubmed ID:
  36877637
• Pubmed Central ID:
  PMC10286694
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; T32 AI007001/AI/NIAID NIH HHSUnited States/ ; UL1 TR002489/TR/NCATS NIH HHSUnited States/ ; UM1 TR004406/TR/NCATS NIH HHSUnited States/
• Volume:
  50
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:9b3ba1b58356455265ba8746e64695fcdf81be8e9a43e3b17c64ff0f636e2d69
• Download URL:
  https://stacks.cdc.gov/view/cdc/130351/cdc_130351_DS1.pdf
• File Type:
  [PDF - 148.23 KB ]