Disseminated gonococcal infection

N. gonorrhoeae is an infection found only in humans. In the United States, an estimated 600,000 new cases occur each year, with the peak incidence occurring in the summer months. Adolescents and young adults are at the highest risk of infection. N. gonorrhoeae affects both men and women. Infection in men typically produces symptoms that lead patients to seek treatment. On the other hand, N. gonorrhoeae infection in women often is asymptomatic and can lead to sterility or ectopic gestation. N. gonorrhoeae becomes disseminated in 1–3% of all gonococcal infections. Disseminated gonococcal infection (DGI) usually presents as an arthritis-dermatitis syndrome; patients experience migrating polyarthalgias usually affecting the knees, elbows, and distal joints. Approximately 75% of patients have a characteristic dermatitis consisting of discrete papules and pustules with a hemorrhagic component. If untreated, the arthritis tends to progress in one to two joints, usually the knee, ankle, elbow, or wrist. Treatment consists of hospitalization, evaluation for serious sequelae such as endocarditis and meningitis, and antibiotic therapy. Additionally, the patient's partner also should be treated. Disseminated gonococcal infection can cause serious complications during pregnancy such as septic abortion or chorioamnionitis, as well as preterm labor and preterm premature rupture of membranes.