By Disease Name > Gonococcemia

Gonococcemia

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otherwise well
often with partially treated gonorrhea
fever, migratory polyarthritis that settles in one joint, scattered lesions pusutles on a hemorrhagic base
joint disease:  (migratory arthritis that settles to one joint)
tenosynovitis blood culture (+), fluid culture (-)
suppurative arthritis blood culture (-), synovial fluid culture (+)   (usually without skin lesions)
initially there may be macules, papule or vesicles with a red halo, but they soon develop into pustules or bullae which may become hemorrhagic or necrotic
occur early in one or more crops, each of which consists of relatively few lesions, usually <20 scattered over the limbs

 

 

diagnosis:

certain clinical diagnosis is usually impossible
mucosal infection is often asymptomatic, but a positive culture is often obtained from the site of primary infection
cannot culture organism from blood or pustules, only from original sight of infection oropharynx, cervix, and/or rectum are highest yield
(cause = local hypersensitivity; find antigen but no organism)???
the pustule on a hemorrhagic base are distinctive but not pathognomonic  (ddx also occur in disseminated meningicoccus and acinetobacter spp.)

 

 

Chronic gonococcemia and meningococcemia characterized by triad:

fever
arthritis (migratory)
scattered skin lesions
(but they are ill in meningococcemia, and well-appearing in gonococcemia)