Epidemiology
Etiology
Pathophysiology
Clinical features
Extragenital gonococcal infections
- Gonococcal conjunctivitis
- Affects newborns (vertical transmission) and sexually active individuals
- Manifests as hyperacute conjunctivitis
- Gonococcal pharyngitis
- Sore throat
- Pharyngeal exudate
- Cervical lymphadenitis
Diagnostics
- Gram stain
- Findings: polymorphonuclear leukocytes and intracellular gram-negative diplococci
- Findings: polymorphonuclear leukocytes and intracellular gram-negative diplococci
Treatment
Disseminated gonococcal infection (DGI)
Etiology
Hematogenous spread of N. gonorrhoeae from an untreated mucosal gonococcal infection
Clinical features
DGI typically manifests as gonococcal arthritis without symptoms of a localized mucosal infection.
- Arthritis-dermatitis syndrome
- Polyarthralgias: migratory, asymmetric arthritis that can become purulent
- Tenosynovitis: simultaneous inflammation of several tendons (e.g., in the fingers, toes, wrists, ankles)
- Dermatitis
- Vesicular, pustular, or maculopapular lesions, possibly with a necrotic or hemorrhagic center
- Distribution: acral (i.e., the extensor surfaces of the hands and feet, sometimes involving the palms and soles), the trunk
- Purulent gonococcal arthritis
- Abrupt monoarticular or oligoarticular inflammation
- Commonly affects knees, ankles, elbows, and wrists
- Skin manifestations and tenosynovitis are typically absent.