The Open Arthritis Journal
2009, 2 : 18-21Published online 2009 October 1. DOI: 10.2174/1876539400902010018
Publisher ID: TOARTHJ-2-18
RESEARCH ARTICLE
Peri-Arthritis and Tenosynovitis with a Ciprofloxacin-Resistant Gonococcal Strain
2 Department of Nuclear Medicine, Medisch Centrum Leeuwarden, 8934 AD Leeuwarden, Netherlands
3 Department of Dermatology and Venerology, Academisch Medisch Centrum, Amsterdam, Netherlands
4 Department of Medical Microbiology, Laboratory of Public Health, Leeuwarden, The Netherlands
* Address correspondence to this author at the Department of Rheumatology, Medisch Centrum Leeuwarden, 8934 AD Leeuwarden, The Netherlands; Tel: +31582866104; Fax: +31582866105; E-mail: gawbruyn@wxs.nl
ABSTRACT
Disseminated gonococcal infection (DGI) occurs in only a small minority of mucosal infections with Neisseria gonorrhoeae. Clinical manifestations of DGI include skin lesions, fever and musculoskeletal involvement. Articular manifestations include arthralgia, tenosynovitis, peri-arthritis and arthritis. Useful imaging techniques in DGI are multiphase bone scintigraphy and grey-scale ultrasonography with power Doppler modality. Sonography provides a reliable way to detect and aspirate fluid, which can be used for microbial diagnosis. Besides diagnostic purposes, cultivation allows determination of antimicrobial susceptibility, which may have implications for therapy. Since quinolone-resistant gonococcal infection continues to spread, treatment recommendations have changed to administration of cephalosporins in different parts of the world