Sun Hsin-Yun, Chang I-Chern, Chen Mei-Jyh, Hung Chien-Ching, Chang Shan-Chwen
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
J Formos Med Assoc. 2004 Nov;103(11):858-9.
Acute urethritis and arthritis-dermatitis syndrome after sexual contact are often assumed to be caused by Neisseria gonorrhoeae. We report a case of arthritis-dermatitis syndrome in a 32-year-old man who presented with generalized maculopapular and petechial skin lesions and polyarthritis. Acute urethritis developed 1 week after oro-genital sexual contact with a sex worker about 3 weeks before admission. No pathogen was found on smear of urethral discharge and skin lesions, but Gram-negative diplococci were noted in joint fluid, and blood culture yielded N. meningitidis. His condition improved gradually after repeated arthrocentesis and antibiotic therapy with ceftriaxone followed by ciprofloxacin. Oro-genital contact is a transmission route for N. meningitidis infection manifesting as acute urethritis and arthritis-dermatitis syndrome.
性接触后出现的急性尿道炎及关节炎 - 皮炎综合征通常被认为是由淋病奈瑟菌引起的。我们报告一例32岁男性的关节炎 - 皮炎综合征病例，该患者出现全身性斑丘疹和瘀点性皮肤损害以及多关节炎。在入院前约3周与一名性工作者进行口交性接触1周后，患者出现急性尿道炎。尿道分泌物和皮肤损害涂片未发现病原体，但关节液中发现革兰氏阴性双球菌，血培养分离出脑膜炎奈瑟菌。经反复关节穿刺及头孢曲松随后环丙沙星抗生素治疗后，患者病情逐渐好转。口交性接触是脑膜炎奈瑟菌感染表现为急性尿道炎及关节炎 - 皮炎综合征的传播途径。
