Gonococcal bacteremia

Alternative names

Gonococcemia (disseminated)

Definition

Gonococcemia (disseminated) is a sexually-transmitted disease caused by the bacterium Neisseria gonorrhoeae, which spreads from the initial site of infection through the bloodstream to other parts of the body.

Causes, incidence, and risk factors

Gonorrhea is one of the most commonly reported sexually transmitted infectious diseases. It is transmitted through vaginal, oral, and anal intercourse. 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 who live in high-density urban areas. Multiple unprotected sexual partners is a risk factor.

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

Symptoms

• Fever
  
• Chills, malaise
  
• Joint pain, either single or multiple joints (knee pain, wrist pain, ankle pain)
  
• Joint swelling (knees, wrists, ankles)
  
• Skin rash: begins as flat, pink-to-red spots that evolve into raised, pus-filled bumps
  
• Painful tendons of wrists or heels
  
• A combination of skin rash and aching, swollen tendons - sometimes known as tenosynovitis-dermatitis syndrome
  

Signs and tests

• Blood culture
  
• Skin lesion culture
  
• Culture of synovial fluid from joints
  
• Urethral discharge culture
  
• Culture from endocervix
  
• Throat culture
  
• Anal culture
  

Treatment

There are two aspects of treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first aspect is to cure the affected person. The second is to locate and test all of the other sexual contacts and to treat them to prevent further spread of the disease.

That is why mandatory reporting has been instituted and has, until recently, held the number of cases of gonorrhea at a low level. However, the incidence is once again rising.