Neisseria gonorrhoeae can disseminate hematogenously. The most common manifestation of disseminated gonococcal infection (DGI) is:

• A Meningitis with purulent CSF
• B Arthritis-dermatitis syndrome — migratory polyarthralgia, tenosynovitis, and pustular/necrotic skin lesions ✓
• C Endocarditis with vegetation on aortic valve
• D Pelvic inflammatory disease progressing to perihepatitis

Explanation

DGI affects 0.5–3% of untreated gonorrhea cases. The arthritis-dermatitis syndrome is the most common presentation: migratory polyarthralgia/polyarthritis, tenosynovitis (especially wrists, fingers, ankles), and skin lesions (2–10 pustular/hemorrhagic vesiculopustules on acral surfaces). This is caused by immune complex deposition. Localized septic arthritis (typically monoarthritis) is less common but represents the other DGI form. Penicillinase-producing strains are an important resistance concern.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.