title: A case of bacteremia by Neisseria gonorrhoeae coincident with massive hemorrhage of esophageal varices.
abstract: A 42-yr-old man with hepatitis B virus associated liver cirrhosis was admitted to the emergency room because of multiple seizures, a history of chills and myalgia over the previous 2 weeks, and 3 days of melena. He was febrile with a temperature of 38.0°C. There were no symptoms and signs related to the genitourinary system, skin, or joints. Three sets of blood cultures were obtained and oxidase-positive, gram-negative diplococci were detected after 25.9-26.9 hr of incubation in all aerobic vials. The organism was positive for catalase and oxidase, and was identified as Neisseria gonorrhoeae, using a Vitek Neisseria-Haemophilus Identification card (bioMérieux Vitek, Inc., USA). Further, 16S rRNA sequencing of this isolate revealed a 99.9% homology with the published sequence of N. gonorrhoeae strain NCTC 83785 (GenBank Accession No. NR_026079.1). Acute bleeding by variceal rupture seems to be a likely route of introduction of N. gonorrhoeae from the mucosa into the blood. To the best of our knowledge, this is the first case of gonococcal bacteremia in Korea.
authors.affiliation: Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Dahae
authors.initials: D
authors.lastname: Won
authors.forename: Dongheui
authors.initials: D
authors.lastname: An
authors.forename: Mi-Na
authors.initials: MN
authors.lastname: Kim
authors.forename: Young Sang
authors.initials: YS
authors.lastname: Lee
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D002374:Catalase / Q000378:metabolism; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000175:diagnosis*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006069:Gonorrhea / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D008026:Ligation; D008103:Liver Cirrhosis / Q000175:diagnosis; D008297:Male; D009344:Neisseria gonorrhoeae / Q000235:genetics / Q000302:isolation & purification*; D010088:Oxidoreductases / Q000378:metabolism; D012336:RNA, Ribosomal, 16S / Q000737:chemistry / Q000235:genetics; D017422:Sequence Analysis, DNA
chemical_list: D012336:RNA, Ribosomal, 16S; D010088:Oxidoreductases; D002374:Catalase