Critical Care A Day
Saturday May 21, 2022
Saturday May 21, 2022
Q; 35 years old male is admitted to ICU with sepsis and disseminated gonococcal infection (DGI) is suspected. Patient is found to have multiple joints with purulent arthritis. Polyarthritis in DGI is ususally? (select one)
A) symmetric
B) asymmetric
Answer: B
Although with recent advances DGI is less seen but few features of DGI are unique and may help to establish differential diagnoses. Some of the characteristics of DGI are:
- - It is usually of abrupt onset
- - monoarthritis is relatively more common
- - if there is a polyarthritis, is usually asymmetric.
- - Fever is usually not present
- - DGI is unlikely to precced with complain of urethritis
Although a "classic triad" of tenosynovitis, dermatitis, and polyarthralgia is described but is not always present.
#ID
#STDs
References:
1. Birrell JM, Gunathilake M, Singleton S, Williams S, Krause V. Characteristics and Impact of Disseminated Gonococcal Infection in the "Top End" of Australia. Am J Trop Med Hyg. 2019 Oct;101(4):753-760. doi: 10.4269/ajtmh.19-0288. PMID: 31392956; PMCID: PMC6779203.
2. Bardin T. Gonococcal arthritis. Best Pract Res Clin Rheumatol 2003; 17:201.
3. Rice PA. Gonococcal arthritis (disseminated gonococcal infection). Infect Dis Clin North Am 2005; 19:853.