Gonococcal arthritis: case series of 58 hospital cases.
Bacterial arthritis
Gonococcus
Neisseria gonorrhoeae
Tenosynovitis
Journal
Clinical rheumatology
ISSN: 1434-9949
Titre abrégé: Clin Rheumatol
Pays: Germany
ID NLM: 8211469
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
17
02
2022
accepted:
09
05
2022
revised:
19
04
2022
pubmed:
20
5
2022
medline:
17
9
2022
entrez:
19
5
2022
Statut:
ppublish
Résumé
Extra-genital manifestations of gonococcal infection are rare (0.5-3%). Among them, gonococcal arthritis (GA) is the most frequent, accounting for 30-90% of disseminated infections. Our study aimed to describe all hospital cases of GA in Reunion Island, a French overseas territory. We conducted a retrospective, multicentric, observational study of all cases of certain, probable or possible GA from 2008 to 2020. We identified 58 cases of GA, mostly certain cases (n = 48). Sex ratio was balanced, but men were older than women (51 vs 27 years, p < 0.001). A total of 41% had travelled abroad during the previous 3 months, mostly in Madagascar or South-East Asia. The most frequently infected joint was the knee, followed by ankle, wrist and fingers or carpal joints. Only 16% of cases had genital symptoms, but 50% had another extra-genital manifestation, mainly skin lesions (40%). Positivity rate of joint puncture was 91%, with a purulent liquid. Only 58% had a positive culture, and 33% had only a positive PCR. There was no 3GC-resistant strain. In comparison with gonococcal infection without arthritis, patients were older and had fewer genital but more extra-genital symptoms. On discharge 60% had persistent articular symptoms. GA represented 18% of all hospitalised septic arthritis cases with microbial identification in 2019. GA is rare but it is important to make an early diagnosis and treat promptly, as joint destruction may be important, leading to persistent symptoms after discharge. PCR use in joint puncture is useful in cases with negative culture.
Identifiants
pubmed: 35590115
doi: 10.1007/s10067-022-06208-w
pii: 10.1007/s10067-022-06208-w
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2855-2862Informations de copyright
© 2022. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).
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