Disseminated gonococcal infection presenting as vasculitis: a case report
- 1Department of Microbiology, Mid Staffordshire General Hospital, Stafford, Staffordshire, UK
- 2Department of Rheumatology, Mid Staffordshire General Hospital, Stafford, Staffordshire, UK
- Correspondence to:
Dr S Jain
Mid Staffordshire General Hospital, Stafford, Staffordshire ST16 3SA, UK;
- Accepted 23 February 2006
A 50-year-old man with alcoholic liver disease presented with fever, tenosynovitis, polyarthritis and a vasculitic rash on the hands and feet for 4 days. He had neutrophilia and raised inflammatory markers. He had no history of sore throat, urethral discharge or travel abroad. His initial blood cultures were negative, and he was treated for vasculitis with steroids. The rash and arthritis seemed to improve initially, but he had another episode of fever. Repeat blood cultures grew Neisseria gonorrhoeae,and he received intravenous ceftriaxone followed by oral ciprofloxacin. He had marked improvement in rash, tenosynovitis and arthritis, and the fever dropped. He also had chlamydial urethritis and received azithromycin. The presentation of disseminated gonococcal infection after a presumptive episode of asymptomatic urethral gonorrhoea is highlighted.
Competing interests: None declared.