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Gonococcal arthritis

Definition

Gonococcal arthritis is an infection, usually of a single joint (in 90-95% of cases) that occurs with gonorrhea.

Causes, incidence, and risk factors

This infection occurs in people who have been infected with gonorrhea. It affects women four times more often than men, and is most common 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, and a second, less common, form in which 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 (1-mm to 2-cm red macules). This episode may end as a single joint becomes infected. The most commonly involved joints are the large joints such as the knee, wrist, and ankle.

Symptoms

Signs and tests

Treatment

There are two aspects of treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infected person. The second is to locate, test, and treat all sexual contacts of the infected person to prevent further spread of the disease.

Mandatory reporting has been instituted and has, until recently, held the number of cases of gonorrhea at a low level. However, the number of gonorrhea cases is once again rising.

Beginning about the time of the Vietnam war, the United States saw the appearance of strains of gonorrhea that are resistant to penicillin and tetracycline. 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 and Prevention (CDC).

Instead of the standard penicillin treatment, gonorrhea is now treated by a large number of new and very potent antibiotics. Your health care provider will determine the best and most up-to-date treatment.

A follow-up visit 7 days after treatment is important to recheck cultures and confirm the cure of infection.

Expectations (prognosis)

Symptoms usually improve within 1 to 2 days of starting treatment, and full recovery can be expected.

Complications

Untreated, there may be:

  • Persistent discomfort in the affected joints
  • Infertility
  • Other complications of gonorrhea, such as disseminated gonorrhea (spread throughout the body)

Calling your health care provider

Call your health care provider if you experience symptoms suggestive of gonococcal arthritis.

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.

Illustrations

Gonoccocal arthritis
Gonoccocal arthritis
Chondromalacia of the patella
Chondromalacia of the patella

Page Content:

Disseminated gonococcal infection (DGI)