Gonococcemia (Disseminated)

Alternative names:

gonococcal bacteremia

Definition:

A sexually-transmitted disease caused by the bacterium Neisseria gonorrhoeae, which spreads from initial site of infection through the bloodstream to other organs of the body.

Causes, incidence, and risk factors:

Gonorrhea is the most common reported infectious diseases and is transmitted during sexual intercourse or other sexual activity including oral and anal sex. An infected woman may also transmit the infection to her newborn during childbirth. Gonorrhea in children older than newborns is a sign of sexual abuse.

Gonorrhea is most prevalent in those 15 to 29 years old. Multiple sexual partners is a risk factor.

Disseminated gonococcemia generally follows the primary genital infection by several days to 2 weeks. The infection spreads from the primary site through the bloodstream. Newborns are at increased risk for disseminated gonorrhea.

Dissemination of the bacteria is heralded by fever, chills, malaise, achy tendons, joint aches (either multiple joints or a single joint) and a skin rash. The combination of skin rash and aching swollen tendons is sometimes known as tenosynovitis-dermatitis syndrome. The classical rash associated with gonococcemia begins as flat pink to red spots (macules) which evolve into raised pus-filled bumps (pustules). The tendons are swollen and painful and the skin over the tendons may become reddened.

Joint pain and arthritis in the knees, ankles, and wrists is common. Inflammation of the lining of the heart (endocarditis) and inflammation of the lining of the brain or spinal cord (meningitis) are rare complications.