title: Acute urethritis and arthritis-dermatitis syndrome due to Neisseria meningitidis.
abstract: Acute urethritis and arthritis-dermatitis syndrome after sexual contact are often assumed to be caused by Neisseria gonorrhoeae. We report a case of arthritis-dermatitis syndrome in a 32-year-old man who presented with generalized maculopapular and petechial skin lesions and polyarthritis. Acute urethritis developed 1 week after oro-genital sexual contact with a sex worker about 3 weeks before admission. No pathogen was found on smear of urethral discharge and skin lesions, but Gram-negative diplococci were noted in joint fluid, and blood culture yielded N. meningitidis. His condition improved gradually after repeated arthrocentesis and antibiotic therapy with ceftriaxone followed by ciprofloxacin. Oro-genital contact is a transmission route for N. meningitidis infection manifesting as acute urethritis and arthritis-dermatitis syndrome.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Hsin-Yun
authors.initials: HY
authors.lastname: Sun
authors.forename: I-Chern
authors.initials: IC
authors.lastname: Chang
authors.forename: Mei-Jyh
authors.initials: MJ
authors.lastname: Chen
authors.forename: Chien-Ching
authors.initials: CC
authors.lastname: Hung
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
mesh_terms: D000328:Adult; D001168:Arthritis / Q000382:microbiology*; D003872:Dermatitis / Q000382:microbiology*; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000175:diagnosis*; D009345:Neisseria meningitidis / Q000302:isolation & purification*; D013577:Syndrome; D014526:Urethritis / Q000382:microbiology*