Background

Gonococcal arthritis is a bacterial infection of the joint, caused by the sexually transmitted bacterium Neisseria gonorrhoeae. It is a clinical symptom of a gonococcal infection which has spread to the joints. Arthrits-dermatitis and septic arthritis are two important clinical forms of this condition.

Epidemiology

Disseminated gonococcal infection occurs in about 0.5% to 3% of patients infected with Neisseria gonorrhoeae. Historical data shows that Nesisseria gonorrhoeae were associated with up to 14% of arthritis patients in the 1980s, but recent epidemiologic studies lack recent data. All age groups are susceptible to gonococcal arthritis, but it’s the most common in young and healthy adults.

Anatomy

Pathophysiology

Disseminated gonococcal infection (DGI) is associated with a number of host risk factors, including the use of IUDs, menstruation, pregnancy, complement deficiencies, and a history of pelvic surgery. Various strains of Neisseria gonorrhoeae exhibit virulence factors linked to dissemination.

Among them are strains with the porin 1A outer membrane, which promotes resistance, diminished host inflammation, and host cell invasion, as well as strains requiring specific substrates needed for growth.

The pathogenesis of DGI has also been hypothesized to be partly immunological. The fact that the pathogen is frequently not isolated from both synovial fluid and blood of patients with dissemination is evidence of this.

Etiology

The pathogen responsible for gonococcal arthritis is Neisseria gonorrhoeae, a gram-negative diplococcus.

Sexually active adolescents are susceptible to bacterial arthritis caused by this infection.

A gonococcal infection may also occur in newborns from perinatal infection during childbirth.

Genetics

Prognostic Factors

DGI arthritis has an extremely favourable prognosis if treated properly. In certain cases where treatment is started at an advanced stage, or is inadequate complications like osteomyelitis, endocarditis, meningitis, and perihepatitis.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

Future Trends

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK470439/