Disseminated gonococcal infection

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Neisseria gonorrhoeae causes disseminated gonococcal infection (DGI), the most common form of infectious arthritis seen in both community and major teaching hospitals. The epidemiology, bacteriology, pathology, clinical manifestations, diagnosis, recommended treatment, complications, and prevention of DGI of connective tissue and skin are reviewed. The evidence of the need for a classification of DGI that recognizes two separate patterns of disease as opposed to a continuum is discussed. A classification that recognizes two separate patterns of disease (a tenosynovitis-dermatitis and a suppurative arthritis) is used to analyze and compare data from an earlier published study with a more recent investigation. The results of this analysis demonstrate the utility of the classification. This classification, based on the presence or absence of a synovial effusion, aids in diagnosis, allows prediction of complications and length of hospitalization, and suggests when oral antibiotic regimens may be used.