Cutaneous manifestations of disseminated gonococcemia.
BACKGROUND
Sexually transmitted infections, includingurogenital gonorrheal infection, are a growing healthconcern in the United States. Nearly 50% of cervicalinfections are asymptomatic. If left undiagnosedand untreated, there is a risk of disseminatedinfection.


OBJECTIVE
To describe an 18-year-old womanpresenting with disseminated gonococcal infectionconfirmed by blood cultures, skin biopsy, and urinegonococcal probe. We also describe the presentation,diagnosis, and treatment of disseminated gonococcalinfection, including discussion of the variousmorphologies of cutaneous lesions that have beenreported in the literature.


METHODS
Thefeatures of a woman with disseminated gonococcalinfection are presented. Using PubMed, the termscutaneous, disseminated, gonococcal, gonorrhea,infection, lesions, manifestations, pustules, skin, andsystemic were searched. Relevant citations wereutilized and discussed.


RESULTS
Hemorrhagic pustules,petechiae, and purpuric lesions developed in a youngwoman with fever and joint pain. Blood cultures grewbeta lactamase negative Neisseria gonorrhoeae andthe Neisseria gonorrhoeae/Chlamydia trachomatisprobe was positive for both N. gonorrhoeae and C.trachomatis. Biopsy revealed bulla with neutrophils,extravasated erythrocytes, fibrin deposits in the vesselwalls, and leukocytoclasia.


CONCLUSIONS
Cutaneouslesions of disseminated gonococcal infection caninclude abscesses, cellulitis, petechiae, purpuricmacules, necrotizing fasciitis, and vasculitis. It isimportant for the clinician to recognize the clinicalsigns and symptoms of disseminated gonococcalinfection, particularly the various cutaneousmanifestations.
Medical School, Louisiana State University Health Sciences Center, New Orleans. Sbeat2@lsuhsc.edu.
Surget V
SV
Beatrous
Stratton B
SB
Grisoli
Ryan R
RR
Riahi
Ryan J
RJ
Matherne
Ryan J
RJ
Matherne
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000188:drug therapy; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy; D002443:Ceftriaxone / Q000627:therapeutic use; D003872:Dermatitis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D009344:Neisseria gonorrhoeae
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone