Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/11103
Title: Case Report: Severe Disseminated Gonococcal Infection with Polyarticular Gout: Two Cases in Older Travelers.
Authors: Smith, Emma L
Hodgetts, Kay E
Ralph, Anna P
Anstey, Nicholas M
Affiliation: Division of Medicine, Royal Darwin Hospital, Darwin, Australia..
Division of Medicine, Royal Darwin Hospital, Darwin, Australia..
Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia.. Division of Medicine, Royal Darwin Hospital, Darwin, Australia..
Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia.. Division of Medicine, Royal Darwin Hospital, Darwin, Australia..
Issue Date: Jan-2019
Citation: The American journal of tropical medicine and hygiene 2019-01; 100(1): 209-212
Abstract: Two male travelers with histories of gout and hazardous alcohol consumption, presented with a triad of severe culture-positive disseminated gonococcal infection, crystal-positive polyarticular gout, and gonococcal soft tissue collections, following unprotected sexual contact in The Philippines. Both men initially attributed symptoms to gout, since their usual joints were affected, but clinical deterioration occurred with self-administration of anti-inflammatory agents alone. The clinical courses were severe and protracted, requiring aggressive management of infection with prolonged intravenous antimicrobials and repeated surgery, and prolonged anti-inflammatory agents for gout. Joint symptom onset in each case occurred within a week of sexual exposure in conjunction with hazardous alcohol ingestion. We speculate that acute dissemination of infection to previously damaged joints triggered polyarticular gout, with progressive infection, exacerbated by unopposed anti-inflammatory agents and delayed antibiotics. Disseminated gonococcal infection can occur with polyarticular gout and delays in recognition and treatment, including while traveling, can lead to severe disease from both.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/11103
DOI: 10.4269/ajtmh.18-0589
Type: Journal Article
Appears in Collections:NT Health digital library

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