Tenosynovitis gonococcal arthritis. Tender, hemorrhagic pustules ranging from 0.

Tenosynovitis gonococcal arthritis Classic DGI typically manifests as a combination of dermatitis, tenosynovitis, and migratory polyarthralgia, or as purulent arthritis without skin lesions. The initial symptoms include fevers, chills, and migratory Two clinical presentations which may overlap: 1) Triad of migratory tenosynovitis, vesicular or pustular dermatitis, and polyarthralgias without purulent arthritis, aka arthritis-dermatitis syndrome, 2) 25-50% develop a mono- or oligo-arthritis with purulent joint effusions typically of knees, wrists, or ankles. Features of gonococcal tenosynovitis include the following: Apr 9, 2019 · Gonococcal arthritis is a type of septic arthritis, which means that the joint symptoms are caused by an infection in the joint. This condition is also rare. Certain joint diseases, such as rheumatoid arthritis, systemic sclerosis, gout, diabetes, and reactive arthritis, can increase the risk of tenosynovitis. Code History. [QxMD MEDLINE Link]. Use of sonography in the early detection of suppurative flexor tenosynovitis. Hand flexor tenosynovitis in rheumatoid arthritis. Gonococcal arthritis (disseminated gonococcal infection). Jul 3, 2023 · Septic arthritis is joint inflammation secondary to an infectious etiology, usually bacterial, but occasionally fungal, mycobacterial, viral, or other uncommon pathogens. Aug 21, 2024 · Gonococcal flexor tenosynovitis most commonly affects sexually active teenagers and young adults. 22. 221. Tender, hemorrhagic pustules ranging from 0. . 2016 (effective 10/1/2015): New code (first year of non-draft Gonococcal bacteremia is more likely to be associated with polyarthralgias and skin lesions. A young male with arthritis and skin lesions. Disseminated gonococcal infection (DGI) results from bacteremic spread of the sexually transmitted pathogen, Neisseria gonorrhoeae, which can lead to a variety of clinical symptoms and signs, such as arthritis or arthralgias, tenosynovitis, and multiple skin lesions. Ninety-four patients (88. It is demonstrated by tenderness along the flexor sheath and pain on a passive extension during a physical examination. Thompson SE 3rd, Jacobs NF Jr, Zacarias F, Rein MF, Shulman JA JAMA 1980 Sep 5;244(10):1101-2. Disseminated gonorrhea usually presents in two distinct patterns: (1) a triad of tenosynovitis, dermatitis with petechial or pustular skin lesions, and polyarthralgias or (2) suppurative arthritis that is usually limited to one joint. Factors that increase the likelihood of disseminated gonococcal infections include. Neisseria gonorrhoeae is a mucosal infection that has the propensity to disseminate, causing symptoms that commonly include arthralgias, skin lesions, fevers, chills, dysuria, genital discharge, septic arthritis, and/or tenosynovitis. One of these cultures is positive in approximately 80% of patients. Aug 7, 2023 · Gonococcal arthritis results from sexually transmitted bacteria Neisseria gonorrhea; a gram-negative diplococcus, when spread in blood, can lead to disseminated gonococcal infection (DGI). Disseminated gonorrhea is diagnosed infrequently, partly due to low suspicion at the time of presentation, and at times, due to overlapping symptoms associated with non-infectious conditions like systemic lupus erythematosus (SLE). Rice, MD Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Lazare Research Building (LRB), Room 321, 364 Plantation Street, Worcester, MA 01605, USA Neisseria gonorrhoeae was once the most common cause of septic arthritis Aug 21, 2024 · Along with septic arthritis, gonococcal tenosynovitis may occur in isolation without symptoms consistent with dissemination. 4-5 Mar 31, 2014 · In bacteraemic form, clinical features include migratory polyarthralgia (knees, elbows and ankles), moderate fever, chills, vesicular or pustular lesions, tenosynovitis (50 to 60% of cases of gonococcal arthritis ) particularly extensor tendon of the hands, wrists, fingers, toes and ankles. Apr 1, 2003 · Gonococcal arthritis was a leading type of septic arthritis among young adults 3. Treatment recommendations were based on now outdated guidelines. It can be either monoarticular (40% of the time) or a combination of tenosynovitis, polyarthralgia or migratory polyarthritis, and skin lesions (60% of the time) . University of Florida Health University of Florida (352) 733-0111 My UFHealth Make a Gift. FREQUENCY Gonococcal arthritis is the most frequent type of acute septic arthritis seen in young, sexually active adults. It can present as a triad of symptoms like vesiculopustular skin lesions, tenosynovitis, and arthritis (arthritis-dermatitis syndrome). N gonorrhoeae accounts for only 20% of cases of monoarticular septic arthritis in young adults, since the most common joint presentation of DGI involves an oligoarthritis or polyarthritis. Disseminated gonococcal infection (DGI) is an important mucosal infection caused by Neisseria gonorrhoeae but is rare. Sep 16, 2024 · Whereas case reports have been published of N. Gonococcal arthritis of the shoulder and septic extensor tenosynovitis of the wrist: sonographic appearances. RECOVERY FOLLOWS AN ILLNESS OF THREE MONTHS' DURATION A thirty-four-year-old white woman enters the hospital complaining of pain in the chest and joints. Gonococcal bacteremia is commonly documented in this form of the disease with positive blood cultures in up to 50% of DGI patients with tenosynovitis and polyarthralgias, suggesting that the synovium and periarticular tissues are Gonococcal arthritis is also common in men who have sex with men, whose high incidence of asymptomatic gonococcal pharyngitis and proctitis predisposes them to disseminated gonococcal infection. The other form consists of purulent arthritis with or without other associated symptoms . An immunologic basis has been postulated for the polyarthralgias and skin lesions of DGI , but DGI may result directly from synovial and periarticular infection. Infect Dis Clin North Am. 2. Incidence of de Quervain's tenosynovitis in a young, active population. World Health Organization. The evidence of the need for a classification Our patient was diagnosed with disseminated gonococcal disease, showing a combination of arthralgia, tenosynovitis and polyarticular purulent arthritis. ) “Fluoroquinolones no longer recommended for treatment of gonococcal infections”. gonorrhoeae infection. 19 Some authors have postulated an immunologic Sep 5, 1980 · Twenty-three patients with disseminated gonococcal infections--15 with acute tenosynovitis, six with septic monoarticular arthritis, and two with both--were randomly given five days of erythromycin stearate or estolate, 500 mg orally every six hours (13 patients), or crystalline aqueous penicillin G … Sep 18, 2024 · The Disseminated Gonococcal Disease (DGI) presents with varying signs and symptoms such as arthralgias and skin lesions to less commonly tenosynovitis posing a diagnostic challenge. Jun 5, 2016 · DGI usually presents with the clinical triad of polyarthritis, tenosynovitis, and dermatitis. DGI occurs when the sexually transmitted pathogen Neisseria gonorrhoeae invades the bloodstream and spreads to distant sites in the body, leading to clinical manifestations such as septic arthritis, polyarthralgia, tenosynovitis, petechial/pustular skin lesions, bacteremia, or, on rare diagnosis, and treatment of nongonococcal and gonococcal arthritis only. Typically, gonococcal tenosynovitis affects the flexor sheath and is associated with arthralgias, skin lesions, or both. The incidence has subsequently decreased mainly due to the implementation of effective control programmes, and, at present, gonococcal infections are rare in Europe and North America [4,6,7,14] . 2- Non-gonococcal septic arthritis, affects larger joints of lower extremity. Intravenous penicillin vs oral erythromycin. Disseminated gonococcal infection (DGI) frequently results in petechial or pustular acral skin lesions, asymmetric polyarthralgia, tenosynovitis, or oligoarticular septic arthritis (899–901). Among them, gonococcal arthritis (GA) is the most frequent, accounting for 30-90% of disseminated infections. 2,5e8 However, no case reports exist of isolated gonococcal extensor tenosynovitis. “Gonococcal arthritis (disseminated gonococcal infection)”. Gonorrhea is a sexually transmitted infection caused by gram-negative diplococci, Neisseria gonorrhoeae. November 2019; IDCases 19(4):e00662; who developed the sudden onset of right wrist pain and swelling with associated left second finger tenosynovitis Gonococcal arthritis may take one of two forms: a classic suppurative arthritis similar to the septic arthritis seen with other bacterial infections or a syndrome of disseminated gonococcal infection (DGI) including tenosynovitis, skin lesions, and polyarthralgias without true septic arthritis. Gonococcal Arthritis (Disseminated Gonococcal Infection) Peter A. 49 is grouped within Diagnostic Related Group(s) (MS-DRG v 42. These disorders are important since DGI may be the most frequent form of acute arthritis in sexually … Twenty-three patients with disseminated gonococcal infections—15 with acute tenosynovitis, six with septic monoarticular arthritis, and two with both—were randomly given five days of erythromycin stearate or estolate, 500 mg orally every six hours (13 patients), or crystalline aqueous penicillin G While the arthritis of disseminated gonococcal infection can affect large joints, it equally affects small joints causing inflammation, and a characteristic tenosynovitis that differentiates it from other forms of septic arthritis . Disseminated gonococcal infection usually manifests as arthritis, dermatitis, and tenosynovitis. Can be differentiated by microbiological tests. gonorrhoeae In this report, we describe the case of a young woman with tenosynovitis, arthritis and skin lesions as first manifestations of a gonococcal infection. 2 Characteristic cutaneous lesions are scattered small-sized purpuric macules on palms and soles, which can evolve into vesicopustules with hemorrhage. 12. doi pubmed; Rice PA. 2018;33(3):387-388. Although rare, DGI can also lead to endocarditis or meningitis The "classic triad" of tenosynovitis, dermatitis, and polyarthralgia was rare. Although it more commonly affects the flexor tendons of the hand, involvement of the extensor tendons has been reported. 2% of septic arthritis cases in North America and Europe. May 28, 2024 · Disseminated gonococcal infection (DGI) results from bacteremic spread of the sexually transmitted pathogen, Neisseria gonorrhoeae, which can lead to a variety of clinical symptoms and signs, such as arthritis or arthralgias, tenosynovitis, and multiple skin lesions. Arch Rheumatol. 37 It is the most frequent type of septic arthritis among young adults of low socioeconomic status, accounting for up to two thirds of Gonococcal arthritis Urethritis/vaginitis may be absent; May have prodromal phase: Migratory arthritis and tenosynovitis predominate before pain and swelling occurs; Macularpapular rash or pustules especially on hands/feet may proceed overt arthritis; Endocarditis should be considered in the presence of 2 or more affected joints; Differential Jan 1, 2006 · Disseminated gonococcal infection (DGI) commonly presents with arthritis, flexor compartment tenosynovitis, and dermatitis. GONOCOCCAL ARTHRITIS Evangeline Scopelitis, MD, and Pindaro Martinez-Osuna, MD Disseminated gonococcal infection (DCI) is a common illness, prevalence of which has variously been estimatedbetween 0. Half of the patients had significant underlying co-morbidities or predisposing factors, including complement deficiency. Arthritis Rheum. 20 GONOCOCCAL ARTHRITIS Evangeline Scopelitis, MD, and Pindaro Martinez-Osuna, MD Disseminated gonococcal infection (DCI) is a common illness, prevalence of which has variously been estimated between 0. doi pubmed; World Health Organization. 3. 6 Although gonococcal tenosynovitis typically presents inpatients with DGI, multiple case reports describe isolated gonococcal flexor tenosynovitis in the absence of other DGI symptoms. Disseminated gonococcal infection. Sep 29, 2020 · The more common form known as arthritis-dermatitis syndrome presents as non-purulent arthritis, tenosynovitis, skin manifestations (rashes) and polyarthralgia . Gonococci are isolated by culture from less than half of patients with gonococcal arthritis. Some patients may experience joint pain, tenosynovitis, or suppurative arthritis, and some may develop gonococcal meningitis, endocarditis, pericarditis, or myocarditis. 31, 32 Gonococcal arthritis can present as a monoarthritis, On examination, there was a petechial and purpuric rash involving the lower extremities and bilateral tenosynovitis of the ankle dorsiflexor tendons. Jul 20, 2022 · INTRODUCTION. Rarely, DGI is complicated by perihepatitis associated with gonococcal PID, endocarditis, or meningitis. 7863/jum. 4 Patients usually present with constitutional symptoms such as fevers and chills in addition to one of the two Feb 1, 2005 · Wrist examination shows tenosynovitis, and shoulder examination reveals pain, warmth, and erythema without effusion. Neonatal disseminated gonorrhea. The arthritis tends to affect Mar 13, 2019 · Rice, PA. 4- Hepatitis C infection, fever, arthralgias, Gonococcal bacteremia is more likely to be associated with polyarthralgias and skin lesions. Osteomyelitis and extensor compartment tenosynovitis caused by DGI is Clinical suspicion of DGI should arise in patients with a classic triad of skin rash, polyarthralgia and tenosynovitis, termed ‘arthritis-dermatitis syndrome’. It is found in the 2025 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2024 - Sep 30, 2025. May 19, 2021 · In less than 3% of cases, gonorrhea develops into disseminated gonococcal infection (DGI), of which there are two main presentations: arthritis-dermatitis syndrome (polyarthralgia, tenosynovitis, and dermatitis) and purulent arthritis (mono- or oligoarticular arthritis without associated skin lesions). 2018. 17 Inadequacies of Aug 21, 2024 · Gonococcal cultures of the urethra or cervix, rectum, and pharynx are appropriate if gonococcal tenosynovitis is suspected. Feb 1, 2022 · Disseminated Gonococcal Infection (DGI) DGI is an uncommon, but severe, complication of untreated gonorrhea. Our study aimed to describe all hospital cases of GA in Reunion Island, a French overseas territory. Tenosynovitis: inflammation of the synovium (the fluid-filled sheath Infectious arthritis is suspected in patients with acute monoarticular or oligoarticular arthritis and in patients with other combinations of symptoms characteristic of particular infectious arthritis syndromes (eg, migratory polyarthritis, tenosynovitis, and skin lesions typical of disseminated gonococcal infection; erythema migrans or other Disseminated gonococcal infection (DGI) consists of gonococcal infection plus one or more of the triad of arthritis, tenosynovitis, and dermatitis. Knees are most commonly affected, followed by wrists, ankles, and elbows. 3 Histologically, epidermal Jun 1, 2018 · Introduction. 34 (1):112-5. Case Report A 27-year-old healthy woman with allergic rhinitis presented to the emergency department (ED) reporting a 4-day history of fever, odynophagia/sore throat, painful skin lesions ( Fig May 29, 2023 · Tenosynovitis is a unique finding in gonococcal arthritis and is usually not seen in other forms of septic arthritis. 2114) (Harrison’s Principles of Internal Medicine , 18 Edition) Feb 1, 1981 · However, in one study of DGi patients with tenosynovitis alone versus arthritis alone no difference in mean duration of presenting joint pain was found. To the best of our knowledge, there has May 1, 1993 · INFECTIOUS ARTHRITIS 0889-857Xj93 $0. J Ultrasound Med. 2009 Jan. Synovial fluid. Craig JG, van Holsbeeck M, Alva M. In people with gonorrhea, especially women, gonococcal bacteria can cause tenosynovitis, usually affecting the tissues of the shoulders, wrists, fingers, hips, ankles, or feet. He met Systemic Inflammatory Abstract. 2. Complement Dissemination of gonococci occurs rarely, but can cause specific syndromes, characterized by tenosynovitis, arthralgia, and skin lesions. 3 We present a case of arthritis When septic arthritis is suspected, empiric antibiotics directed against likely pathogens should be used until confirmatory laboratory data are available. Jul 21, 2014 · Unlike reactive arthritis, gonococcal arthritis and tenosynovitis tend to involve both upper and lower extremities equally, to lack back symptoms, and to be associated with characteristic vesicular skin lesions. Overlap of these forms of DGI can also occur, which was demonstrated by our patient who had a purulent right wrist gonococcal arthritis and also tenosynovitis of a left finger without any associated skin lesions. 7%) presented with purulent arthritis. e. (More extensive review of the pathogenesis and clinical manifestations. Hoving V, Borg EJT. 30 ). 20 (4):1003-8. 19. 5%-3% of gonorrhea cases, usually in the form of either a triad of arthralgia, tenosynovitis, and skin lesions or purulent arthritis. J Hand Surg Am. meningitidis mimicking the arthritis-dermatitis syndrome that is more classically associated with disseminated gonococcal infection (due to Neisseria gonorrhoeae), tenosynovitis without purulent arthritis is an extremely rare manifestation of invasive meningococcal disease, with only a few cases Dec 16, 2022 · Arthritis-dermatitis syndrome Infectious condition An arthropathy caused by N gonorrhea, represented by tenosynovitis with skin rash and fever, frequently with a positive blood culture; the arthralgia of gonococcal infection is most frequently an asymmetric polyarthralgia;1/4 of Patients have just a monoarthralgia; asymmetric joint involvement Oct 1, 2019 · The diagnosis of gonococcal arthritis or DGI is also secure if a mucosal gonococcal infection is documented in the presence of a typical clinical syndrome that responds promptly to appropriate Oct 26, 2020 · In contrast, gonococcal arthritis is often successfully treated with antimicrobial therapy alone and demonstrates a very low rate of complications and an excellent prognosis for full return of The tenosynovitis-dermatitis and suppurative arthritis syndromes. Prosthetic joint infections, fungal, and mycobacterial arthritis are not discussed here because of their unique clinical manifestations. Gonococcal tenosynovitis commonly affects the flexor tendon sheath of the muscles. 4. Gonorrhea is the second most common sexually transmitted infection in the United States. Other rare complications include gonococcal infective endocarditis Gonorrhea generally causes either a suppurative arthritis resembling septic arthritis caused by other bacteria, or a distinct syndrome of disseminated gonococcal infection, with tenosynovitis, skin lesions, and polyarthralgias, rather than frank arthritis. 37 It is the most frequent type of septic arthritis amongyoungadultsof low socioeconomic status, accounting Cultures of likely sites of gonococcal infection are the most important tests to perform for the diagnosis of disseminated gonococcal infection (DGI) and consequent gonococcal arthritis. 5 and3%. Urine NAAT was positive for Neisseria gonorrhea, confirming disseminated gonococcal infection (DGI). The hemorrhagic pustules appear in an acral distribution and are few in number ( Fig. 5 and 3%. Antibiotic coverage in healthy hosts should initially include gram-positive organisms, which account for approximately 80% of nongonococcal monoarthritis cases (Staphylococcus aureus, 60%; non–group A Streptococcus species, 15%; S Tenosynovitis typically affects small joints of upper limbs; however, lower joints can also be affected in rare cases. Feb 24, 2021 · Gonococcal arthritis is often an accompanying symptom of disseminated gonococcal infection. 6%-1. Gonococcal bursitis; Gonococcal synovitis; Gonorrhea, synovitis; ICD-10-CM A54. 0% of nonpenetrating septic arthritis in the Top End and 1,234 days of hospitalization during the study period. 49 to ICD-9-CM. 2003;22:221–224. Host factors, however, influence the expression of the disease: gonococcal arthritis is two to three times more common in women than in men, is especially common during menses and pregnancy, and is rare after age 40. Arthritis and arthralgias can occur in one or more joints and may be migratory. gonorrhoeae), results in disseminated gonococcal infection (DGI), which can lead to a variety of clinical signs and symptoms, such as multiple skin lesions, tenosynovitis and arthralgias/arthritis. A 78-year-old man arrived in the Emergency Department with extensor tenosynovitis of the wrist, dermatitis, and polyarthralgias. Gonococcus typically affects the mucosal surfaces but in rare cases can spread to bloodstream causing disseminated gonococcal infection (DGI). Patients with gonococcal arthritis usually require initial hospitalization Symptoms resolve spontaneously in 30-40% of cases or evolve into a septic arthritis in 1 or several joints. Four of these patients had the characteristic skin lesions of gonococcemia, and two had tenosynovitis, findings that seem to be highly suggestive of gonococcal arthritis. Gray RG, Gottlieb NL. The peripheral blood leukocyte count averages 10,000 cells/mcL (10 × 10 9 /L) and is elevated in less than one-third of patients. doi: 10. Disseminated gonococcal infection (DGI) complicates 1–2% of patients with gonorrhea and presents with one or more of the triad of arthritis (3/4 of patients), tenosynovitis (2/3 of patients), and dermatitis 1, 2, 3. The tenosynovitis of DGI is asymmetric and A classification that recognizes two separate patterns of disease (a tenosynovitis-dermatitis and a suppurative arthritis) is used to analyze and compare data from an earlier published study with a more recent investigation. It is more common in women, especially during pregnancy or after menstruation, when systemic dissemination of gonorrhea is more likely to occur. Symptoms may occur when the bacteria spread through the blood and into the affected joints. Nov 18, 2023 · Gonococcal arthritis is a rare complication of gonorrhea, a sexually transmitted infection. Disseminated gonococcal infection was estimated to cause at least 10. Some of the signs of disseminated gonococcal infection may result from an immunologic reaction to nonviable fragments of the organism's cell wall. Gonococcus is a common cause of acute arthritis among young, sexually active individuals. Blood cultures are positive in less than a third of cases of purulent gonococcal arthritis, as was the case in this patient [2,9]. Though uncommon, septic arthritis is an arthritis or tenosynovitis (n=11); one patient had endocarditis. Jul 20, 2024 · Read this chapter of Quick Medical Diagnosis & Treatment 2022 online now, exclusively on AccessMedicine. The tenosynovitis-dermatitis and suppurative arthritis syndromes. The diagnosis of gonococcal arthritis or DGI is also secure if a mucosal gonococcal infection is documented in the presence of a typical clinical syndrome that responds promptly to appropriate antimicrobial therapy. DGI is a result of the spread of Neisseria gonorrhoeae to the bloodstream (bacteremia) and other parts of the body, which most commonly leads to . This is the second part of an integrated review of disseminated gonococcal infection (DGI) and gonococcal arthritis (GCA). In addition, transiently elevated liver function studies (LFTs) have been described with disseminated gonococcal infection. 5. The initial symptoms include fevers, chills, and migratory . Jun 1, 2018 · Gonorrhea is the second most common sexually transmitted infection in the United States. 4-5. Septic arthritis is usually monoarticular or oligoarticular. The disease has become rare in Western countries since the introduction of effective control programmes, but it still needs to be recognized promptly to avoid systemic, po … Mar 26, 2020 · Disseminated gonococcal infection is a rare, systemic complication of untreated gonorrhea that occurs after sexual transmission and through hematogenous spread of Neisseria gonorrhoeae to distant body sites (1). Keywords: Arthritis-dermatitis syndrome; Disseminated gonococcal infection; Neisseria gonorrhoeae; Skin lesions. In a small percentage of cases (0. Sep 9, 2024 · Whereas case reports have been published of N. Rice PA. Patients Oct 31, 2019 · A case of Purulent Gonococcal Arthritis. meningitidis mimicking the arthritis-dermatitis syndrome that is more classically associated with disseminated gonococcal infection (due to Neisseria gonorrhoeae), tenosynovitis without purulent arthritis is an extremely rare manifestation of invasive meningococcal disease, with only a few cases Aug 21, 2024 · Wolf JM, Sturdivant RX, Owens BD. Neisseria gonorrhoeae infects humans exclusively and can colonize diverse mucosal surfaces and produce local and disseminated infections with potentially serious sequelae. 2003. Oct 3, 2024 · Gonococcal arthritis Menu Close On this page Collapse navigation. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code A54. (Harrison’s Principles of Internal Medicine, 17 Edition Volume 2, p. 2005. Mar 1, 2009 · Nongonococcal and gonococcal arthritis are the | Find, read and cite all the research you need on ResearchGate or a distinct syndrome with tenosynovitis, skin lesions, and polyarthralgia Hoving V, Borg EJT. tenosynovitis, and dermatitis. 3- Anicteric prodrome of hepatitis B, Urticarial skin lesion followed by arthralgia, arthritis or tenosynovitis which clear when the patient become icteric. Gonococcemia (gonococcal arthritis-dermatitis syndrome) represents a systemic infection characterized by fever, arthralgia, tenosynovitis, septic arthritis, and hemorrhagic (or purpuric) pustules. , 58%) compared to those with either arthritis and tenosynovitis (88%)~or arthritis alone (82% DGI usually presents with the clinical triad of polyarthritis, tenosynovitis, and dermatitis. We also used data of patients with gonococcal infections diagnosed in free STI The “classic triad” of tenosynovitis, dermatitis, and polyarthralgia was rare. Tenosynovitis and polyarthralgia may be related to May 11, 2023 · Gonococcal arthritis is a painful condition that occurs from the transmission of Neisseria gonorrhoeae. increasing reports of disseminated gonococcal infection (DGI) cases. 3 to 0. [88] Gonococcal infection accounted for approximately two-thirds of the cases of septic arthritis and tenosynovitis in North America in the 1970s [65]. Infectious arthritis is suspected in patients with acute monoarticular or oligoarticular arthritis and in patients with other combinations of symptoms characteristic of particular infectious arthritis syndromes (eg, migratory polyarthritis, tenosynovitis, and skin lesions typical of disseminated gonococcal infection; erythema migrans or other Gonococcal arthritis is caused by bacteremia from a sexually transmitted N. pp. Oct 1, 2024 · A54. The results of this analysis demonstrate the utility of the classification. He was taken to the operating room for washout of his extensor tendons at the wrist and was subsequently diagnosed with disseminated N. The usual presentation of DGI is rash, polyarthralgia, and tenosynovitis. Objectives: Extra-genital manifestations of gonococcal infection are rare (0. The epidemiology, bacteriology, pathology, clinical manifestations, diagnosis, recommended treatment, complications, and prevention of DGI of connective tissue and skin are reviewed. 42 is a valid billable ICD-10 diagnosis code for Gonococcal arthritis. Report on global sexually transmitted infection surveillance 2018. Eleven of the 12 case-patients were hospitalized, and 4 required surgical intervention. Gonococcal tenosynovitis-dermatitis and septic arthritis. It covers clinical manifestations, spectrum of GCA, diagnosis and treatment. Pain may also be due to tenosynovitis. 00 + . 5. vol. Symptoms of Gonococcal Arthritis Someone with gonococcal arthritis might experience gonorrhea symptoms, such as pain when urinating or noticing discharge, but most women and about half of men will never experience Neisseria gonorrhoeae causes disseminated gonococcal infection (DGI), the most common form of infectious arthritis seen in both community and major teaching hospitals. AccessMedicine is a subscription-based resource from McGraw Hill that features trusted medical content from the best minds in medicine. Gonococcal arthritis is also common in men who have sex with men, whose high incidence of asymptomatic gonococcal pharyngitis and proctitis predisposes them to disseminated gonococcal infection. 5-3%). Jun 15, 2021 · Gonococcal arthritis refers to inflammation in a joint as a result of a gonorrhea infection. Disseminated gonococcal infection occurs in 0. Joint involvement in DGI is manifested by polyarthralgia but never as suppurative arthritis . 2005;19(4):853-861. 7-13,21,24 Gonococcal arthritis may take one of two forms: a classic suppurative arthritis similar to the septic arthritis seen with other bacterial infections or a syndrome of disseminated gonococcal infection (DGI) including tenosynovitis, skin lesions, and polyarthralgias without true septic arthritis. 1,2 It is also the most common cause of newly diagnosed arthritis requiring hospitalization. 8 cm in diameter appear on Arthritis-dermatitis syndrome includes the classic triad of dermatitis, tenosynovitis, and migratory polyarthritis. The bacteremic spread of the sexually transmitted pathogen, Neisseria gonorrhoeae (N. It generally causes painful inflammation of the joints and tissues. 853-61. Septic arthritis is usually monoarticular involving one large joint such as the hip or knee; however, polyarticular septic arthritis involving multiple or smaller joints may also occur. 5 to 3%), the bacteria can spread beyond the initial site of infection through the bloodstream, leading to infections in other areas of the body, with a preference for the joints. and accounted for up to two-thirds of septic arthritis and tenosynovitis seen in North America in the 1970s. Gonorrhea is the most frequently reported communicable disease in the United States, and disseminated gonococcal infection (DGI) remains the most common cause of acute septic arthritis in young sexually active adults. 20 Some authors have postulated an immunologic Sep 24, 2019 · ase report of a patient with extensor tenosynovitis of the hand from disseminated gonorrhea and review the literature. 3 In the past 15 years, the incidence of gonorrhea has We also collected all cases of bacterial arthritis from January 1 st 2019 to December 31 2019 from the main 2 sources (hospital databases, laboratories) to establish the proportion of arthritis from gonococcal origin among all septic arthritis over the 2019 period. 0): 548 Septic arthritis with mcc; 549 Septic arthritis with cc; 550 Septic arthritis without cc/mcc; Convert A54. 1977 May. '~ Patient~ with tenosynovitis alone had a somewhat lower frequency of migra- tory arthralgia (i. Mar 13, 2019 · Rice, PA. Tenosynovitis is often found in the hands and wrists or the feet and ankles. Septic arthritis is an orthopedic emergency requiring urgent joint washout and antibiotics. Aug 1, 2024 · Disseminated gonococcal infection is the causative agent of approximately 0. Gonococcal arthritis results from blood dissemination of Neisseria gonorrhoeae from primary sexually acquired mucosal infection. Unlike typical gonococcal septic arthritis, DGI is not typically associated with positive synovial fluid cultures. Nongonococcal and gonococcal arthritis are the most potentially dangerous and destructive forms of acute arthritis. 42. Neonates with disseminated gonorrhea may develop gonococcal septicemia, arthritis, or meningitis. Endocarditis, meningitis, and osteomyelitis may also occur but are rare arthritis or tenosynovitis alone. The exquisite antibiotic sensitivity of most gonococcal organisms has made outpatient oral therapy r … Nov 6, 2020 · Gonococcal arthritis is a rare complication of the sexually transmitted infection (STI) gonorrhea. 5 Since then, the annual incidence of gonococcal infections, which is an important determinant of disseminated infection, has substantially decreased The primary care physician can diagnose gonococcal arthritis with virtual certainty in the presence of migratory polyarthralgia, tenosynovitis of the upper extremity, and characteristic skin lesions. septic arthritis, polyarthralgia, tenosynovitis, and skin lesions. In contrast to nongonococcal bacterial arthritis, gonococcal arthritis usually occurs in otherwise healthy individuals. , 4. After 2 weeks of treatment with ceftriaxone, the patient improved clinically and analytically, but presented beta-lactam-induced toxicoderma, and ceftriaxone was substituted with quinolones. gonococcal infection. [Google Scholar] 13. ICD 10 code for Gonococcal arthritis. In this case, a 64-year-old male presented to the emergency department with a 2-day history of flu-like symptoms, burning with urination, left ankle pain, erythema, and swelling. Typical presentations of this disorder include tenosynovitis, dermatitis, polyarthralgia, or oligoarticular purulent arthritis affecting the distal joints. However, DGI without a woman with gonococcal infection of the cervix uteri develops chills, fever, acute arthritis, suppurative polyarthritis, tenosynovitis, gonococcal bacteremia and aseptic meningitis. A definite diagnosis may be difficult because disseminated gonococcal infection (DGI) is often associated with sterile cultures. White blood cell count usually ranges from 30,000 to 60,000 cells/mcL (30–60 × 10 9 /L) May 17, 2021 · Tenosynovitis usually presents with skin lesions, whereas septic arthritis is usually present alone. Diagnosis in the emergency department (ED) must be suspected clinically, as confirmatory tests are often not available. Prevalence, distribution, and associated rheumatic features. May 29, 2023 · Tenosynovitis is a unique finding in gonococcal arthritis and is usually not seen in other forms of septic arthritis. Synovial fluid cultures are positive for N gonorrhoeae in no more than 50% of cases [ 1 ] and alone are insufficient to establish the diagnosis. wbsb olhd ntawmsdi xgy vtq lwrtt bjoi taelaubj lmfnnlb pcld hlinz oawlks ctpki pfhfo pconx