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Gonococcal arthritis – gonorrhea infection that affects the joints
December 1, 2020
Gonococcal arthritis is the inflammation of a joint as a result of an infection by the bacteria Neisseria gonorrhoeae. This pathogen is one of the most common causes of Sexually Transmitted Infections (STIs) worldwide, as the World Health Organization (WHO) estimates that 78 million cases occur annually.
In other words, 0.8% of women and 0.6% of men around the world can be carriers of Neisseria at any given time and place. Of these cases, between 0.5% and 3% can lead to gonococcal arthritis. If you want to know more about this pathology, keep reading.
How does gonococcal arthritis occur?
According to the United States National Library of Medicine, gonococcal arthritis occurs when the bacteria that cause gonorrhea spread through the bloodstream to one or more joints, multiplying in the synovial fluid and synovium. This event is also known as a type of Disseminated Goncoccal Infection (DGI).
As indicated in the MSD Manual medical portal, bacteria release toxic products that promote joint inflammation. In addition, the neutrophils of the immune system go to the infected site to release pathogen-destroying enzymes, which also damage the synovium, linkages, and joint cartilage.
It is necessary to emphasize that gonococcal arthritis occurs in less than 50% of the cases of DGI, and is the cause of up to 14% of the episodes of arthritis in some population centers. This event is more common in young people with an active sexual life than in other population groups.
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What are your symptoms?
The symptoms of gonococcal arthritis can vary from person to person. Among the most common clinical signs we find the following:
Inability to move the joint that is infected.
Fever (approximately 60% of cases).
Joint pain for 1-4 days.
Burning when urinating, a sign of the presence of the bacteria in the genitourinary tract of the patient.
On the other hand, medical research separates the clinical pictures produced by the gonorrhea bacteria into two large blocks. These are the following:
Arthritis-dermatitis syndrome: is a form of DGI that includes tendon inflammation, dermatitis, fever, and pain in multiple joints. Dermatological manifestations occur in the form of raised ulcers in 75% of patients on various parts of the body.
Localized septic arthritis: in this case, the infection presents only with symptoms in the affected areas.
How is gonococcal arthritis diagnosed?
The diagnosis of gonococcal arthritis, or indeed any septic arthritis, requires several tests to make an exact approximation. Among the most common diagnostic methods we find the following:
History with study and culture of synovial fluid: a laboratory test to detect infection-causing germs in a sample of the fluid that surrounds a joint.
Blood culture: seeding samples of the patient's blood into different culture media to see if bacteria are present in their blood.
Throat culture, since the bacteria that cause gonorrhea can settle on the mucous membranes in this area.
Urine test for gonorrhea.
X-rays and other diagnostic imaging.
Several diagnostic methods are required, since sometimes just one is not enough to detect the bacteria. For example, blood cultures are only positive for 1/3 of the cases that are infected with Neisseria.
As in any other bacterial infection, going to antibiotics is a must. The first preventive treatment consists of the administration of ceftriaxone, intravenously or intramuscularly. Other antimicrobial drugs, such as certain third-generation cephalosporins, may also be included.
The therapy will last from 7 to 14 days, depending on the person's health status and their response to the prescribed antibiotics. It should be noted that some strains of Neisseria they are resistant to certain antibiotic groups, so treatment will vary according to the situation of each patient.
In addition to treating the patient, it is necessary to follow up all the people who have been in contact with him for two months. This will prevent further spread of the infection.
Are there possible complications?
Without treatment, this disease can lead to persistent joint pain. On the other hand, if the infection spreads to other areas, it can cause inflammation of tissues in the skull and heart, such as meningitis and endocarditis respectively. For these reasons, any disease of a bacterial nature must be treated urgently.
Seeking immediate care improves prognosis
Gonococcal arthritis is a relatively unusual complication of an infection by Neisseria gonorrhoeae. Despite the fact that this sexually transmitted infection (STI) is so widespread in the world, few carrier patients have gonococcal arthritis.
Even so, if you have itching in the genitourinary system, and simultaneously an intense pain has appeared in a joint, it is possible that you are having gonococcal arthritis. With proper treatment, These clinical signs will remit immediately without major complications.
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