title: Disseminated gonococcal infection presenting as vasculitis: a case report.
abstract: A 50-year-old man with alcoholic liver disease presented with fever, tenosynovitis, polyarthritis and a vasculitic rash on the hands and feet for 4 days. He had neutrophilia and raised inflammatory markers. He had no history of sore throat, urethral discharge or travel abroad. His initial blood cultures were negative, and he was treated for vasculitis with steroids. The rash and arthritis seemed to improve initially, but he had another episode of fever. Repeat blood cultures grew Neisseria gonorrhoeae,and he received intravenous ceftriaxone followed by oral ciprofloxacin. He had marked improvement in rash, tenosynovitis and arthritis, and the fever dropped. He also had chlamydial urethritis and received azithromycin. The presentation of disseminated gonococcal infection after a presumptive episode of asymptomatic urethral gonorrhoea is highlighted.
authors.affiliation: Department of Microbiology, Mid Staffordshire General Hospital, Stafford, Staffordshire, UK. sangita.jain@msgh-tr.wmids.nhs.uk
authors.forename: Sangita
authors.initials: S
authors.lastname: Jain
authors.forename: Htet Nwe
authors.initials: HN
authors.lastname: Win
authors.forename: Venkat
authors.initials: V
authors.lastname: Chalam
authors.forename: Lian
authors.initials: L
authors.lastname: Yee
mesh_terms: D001170:Arthritis, Infectious / Q000382:microbiology / Q000473:pathology; D006069:Gonorrhea / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017445:Skin Diseases, Vascular / Q000382:microbiology*; D013717:Tenosynovitis / Q000382:microbiology / Q000473:pathology; D014526:Urethritis / Q000382:microbiology; D014657:Vasculitis / Q000382:microbiology*