Disseminated Gonococcal Infection Presenting as Bacteremia and Liver Abscesses in a Healthy Adult

Herein, we describe a bacteremia caused by Neisseria gonorrhoeae that presented as liver abscesses. The patient had no risk factors for disseminated gonococcal infection. Periodic fever, skin rashes, and papules were present and the results of an abdominal computed tomography scan indicated the presence of small liver abscesses. The results of blood culture and 16S rRNA sequencing of the bacterial isolates confirmed the presence of N. gonorrhoeae. The patient improved with antibiotic therapy.

Antimicrobial Resistance of Neisseria gonorrhoeae Isolated in Korea

Neisseria gonorrhoeae is the causative agent of gonorrhea, one of the most important sexually transmitted diseases. The incidence of gonorrhea is still prevalent and about 50,000 new cases have been reported annually during the late 2000s in Korea. The antimicrobial resistance of N. gonorrhoeae is very prevalent and most isolates are multi-drug resistant to penicillin G, tetracycline, and fluoroquinolones. The incidence of penicillinase-producing N. gonorrhoeae (PPNG) decreased significantly, but high-level tetracycline-resistant N. gonorrhoeae (TRNG) increased recently. The minimum inhibitory concentrations (MICs) of ceftriaxone were within the susceptible range for all isolates, but MIC creep has been apparent and one cefixime-nonsusceptible isolate (0.5 microg/ml) was found. Spectinomycin-resistant isolates remain rare, but caution should be required when dealing with gonococcal pharyngitis.

Disseminated Gonococcal Infection Presenting as Sweet Syndrome / 대한내과학회지

The salient features of Sweet syndrome, also known as acute febrile neutrophilic dermatosis, are pyrexia, elevated neutrophil count, painful red papules, nodules, plaques, and an infiltrate that consists mainly of mature neutrophils diffusely distributed in the upper dermis. In addition to idiopathic forms of the syndrome, malignancies, inflammatory bowel disease, infections, pregnancy, and drugs have been associated with Sweet syndrome. Disseminated gonococcal infection (DGI) results from bacteremic dissemination of Neisseria gonorrhoeae. The most common presentation of DGI is arthritis-dermatitis syndrome. About 75% of DGI patients display a characteristic dermatitis consisting of discrete papules and pustules, often with a hemorrhagic component. We report a case of DGI presenting as Sweet syndrome.

A Case of Concomitant Disseminated Gonococcal Infection with Acute Viral Hepatitis C

Gonorrhea is endemic in developing countries. Frequent sexual contacts are common among travellers to endemic countries and the risk of sexually transmitted disease as gonorrhea is believed to be high. Disseminated gonococcal infection (DGI) results from blood dissemination of Neisseria gonorrhoeae from the primary mucosal infection and is a common cause of infective arthritis in sexually active adults in the USA. The usual manifestations of DGI are dermatitis, tenosynovitis, and septic arthritis. We experienced a case of DGI concomitant with acute viral hepatitis C, probably acquired by sexual contacts in Philippines. A 40-year-old man took a trip to Philippines and stayed for a week. During his stay in Philippines, a hemorrhagic bulla and several pustules developed on his extrimities. Subsequently he suffered from high fever and arthralgia of several joints, including both knee joints. Neisseria gonorrhoeae was identified by culture of an aspirate from the right knee joint and he was managed with ceftriaxone for 3 weeks under the diagnosis of DGI and gonococcal arthritis. During the follow-up at the outpatient clinic, alanine aminotransferase and aspartate aminotransferase levels began to rise and an anti-HCV antibody became positive. Because HCV viral loads were surging up from 56,703 copies/mL to 538,292 copies/mL during the next 4 weeks, interferon-alpha 2b was administered for 6 months with resultant normal liver function tests and undetectable HCV viral loads.

A Case of Concomitant Disseminated Gonococcal Infection with Acute Viral Hepatitis C

Gonorrhea is endemic in developing countries. Frequent sexual contacts are common among travellers to endemic countries and the risk of sexually transmitted disease as gonorrhea is believed to be high. Disseminated gonococcal infection (DGI) results from blood dissemination of Neisseria gonorrhoeae from the primary mucosal infection and is a common cause of infective arthritis in sexually active adults in the USA. The usual manifestations of DGI are dermatitis, tenosynovitis, and septic arthritis. We experienced a case of DGI concomitant with acute viral hepatitis C, probably acquired by sexual contacts in Philippines. A 40-year-old man took a trip to Philippines and stayed for a week. During his stay in Philippines, a hemorrhagic bulla and several pustules developed on his extrimities. Subsequently he suffered from high fever and arthralgia of several joints, including both knee joints. Neisseria gonorrhoeae was identified by culture of an aspirate from the right knee joint and he was managed with ceftriaxone for 3 weeks under the diagnosis of DGI and gonococcal arthritis. During the follow-up at the outpatient clinic, alanine aminotransferase and aspartate aminotransferase levels began to rise and an anti-HCV antibody became positive. Because HCV viral loads were surging up from 56,703 copies/mL to 538,292 copies/mL during the next 4 weeks, interferon-alpha 2b was administered for 6 months with resultant normal liver function tests and undetectable HCV viral loads.

Detection of Chlamydia trachomatis and Ureaplasma urealyticum by Fluorescence Quantitative PCR / 中华医院感染学杂志

OBJECTIVE To discuss the infection rate of Chlamydia trachomatis(Ct) and Ureaplasma urealyticum(Uu) in patients with non-gonococcal infection.METHODS Fluorescence quantitative PCR method was used on 1025 cases and 30 cases of NGU patients for Ct and Uu detection.RESULTS Of 1025 NGU patients,positive Ct alone accounted for 156 cases,the positive rate was 15.22%.505 cases were separate Uu,the positive rate was 49.27%.Ct,Uu mixed in 217 cases,the positive rate was 21.17%.The detection rate was 85.66%.Uu infection rate in women was more than that in men(?2 = 104.56 P0.05).of control group,the Ct Uu Results negative.CONCLUSIONS In NGH patients,Uu is most common pathgen in man and woman.To diagnosis of NGU,Uu and Ct should be followed by Ct infection rate but no gender tested at the same time to avoid missed diagnosis.

Problems and tentative solutions in the control of gonorrhea in the community

Hospitality girls reporting at the Balibago Social Hygiene Clinic, Angeles City between November 1978 and February 1979 for their regular VD check-up were studied. Similarly, hospitality girls seen at the Social Hygiene Clinics at Makati, Pasay City, and Para$aque, Metro Manila were studied from July to November 1978 to compare the prevalence rate of gonococcal infection