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Gonococcal arthritis Causes and Risks:
This infection occurs in people who have been infected with gonorrhea . It affects women more frequently than men (4:1) and its highest incidence is among sexually active adolescent girls. There is also increased risk during menstruation and pregnancy .
Two forms of arthritis exist, one with skin rashes and multiple joint involvement but no demonstrable gonococci in the joint fluid; and a second, less common form where disseminated gonococcemia leads to infection of a single joint
(monoarticular) and joint fluid cultures are positive.
Single joint arthritis follows generalized spread (dissemination) of the gonococcal infection. Dissemination is associated with symptoms of fever , chills multiple joint aches
(arthralgia) and rashes (1mm-2cm red macules). This episode may end as a single joint becomes infected. The most commonly involved joints are the knee, wrist, and ankle.
Prevention:
Prevention consists of following safer sexual practices . Monogamous sexual relations with a known disease-free partner are considered the ideal means of prevention. The use of condoms provides the best protection against gonorrhea and other sexually-transmitted diseases. Treatment of all sexual partners of a known infected person is essential to prevent further spread or
reinfection.
Symptoms:
Signs and Tests:
Treatment:
There are two aspects of treating a sexually transmitted disease, especially one as easily spread as gonorrhea . The first aspect is to cure the affected person. The second is to locate and test all of the other sexual contacts and to treat them to prevent further spread of the disease. That is why mandatory reporting has been instituted and has, until recently, held the number of cases of gonorrhea at a low level. However, the incidence is once again rising.
Beginning about the time of the Viet Nam war the United States saw the appearance of penicillin- and tetracycline-resistant strains of gonorrhea. These resistant strains have been increasing over the last few years. Because of this a new standardized treatment regimen has now been recommended by the Centers for Disease Control (CDC). Instead of the standard penicillin treatment, gonorrhea is now treated by a large number of new and very potent antibiotics.
These treatment regimens include:
INJECTIONS:
Ceftriaxone 125 mg IM (injected into a muscle )
Spectinomycin 2 grams IM (injected into a muscle)
ORAL (by mouth) one-time dose:
Cefixime 400 mg
Ciprofloxacin 500 mg
Ofloxacin 400 mg
Cefuroxime Axotal 1 gram
Cefpodoxime proxetil 200 mg
Enoxacin 400 mg
ORAL (by mouth) multiple dose:
Erythromycin 500 mg, four times per day, for one week
(Note: mg = milligrams)
A follow-up visit 7 days after treatment to recheck cultures and confirm the cure of infection is important.
Prognosis:
Symptoms usually improve within 24 to 48 hours after initiation of treatment. Complete recovery is anticipated with treatment.
Complications:
Untreated, there may be: - persistent discomfort
- other gonorrhea complications, such as disseminated gonorrhea (spread throughout the body)
Call Your Healthcare Provider:
Call your health care provider if you experience symptoms suggestive of gonococcal arthritis.
Gonorrhea is a sexually transmitted disease that causes infection of the genitals. The organisms can spread into the bloodstream (gonococcemia). They frequently lodge in the skin surface, forming a small red infected area. Sometimes a person with severe gonococcemia may have only a few skin lesions.
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