University of Florida College of Medicine, Jacksonville, FL, USA.
J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211012194. doi: 10.1177/23247096211012194.
, a gram-negative coccus, is a major cause of morbidity among sexually active individuals. Hematogenous spread of from the initial site of infection is thought to occur in only 0.5% to 3% of infected patients. Disseminated gonococcal infections can rarely lead to serious sequelae, such as endocarditis or meningitis. In this article, we present a case that demonstrates a rare finding of disseminated gonococcal infection leading to meningitis, complicated by hydrocephalus. The patient in this case initially presented with intermittent polyarthralgias for two years and later developed a rash. Cultures from blood and joint aspirate were negative. Urine nucleic acid amplification test for was also negative. He was initially started on steroids for what was believed at first to be an autoimmune polyarthritis. The patient later developed acute encephalopathy. Head imaging revealed hydrocephalus. Cerebrospinal fluid analysis was consistent with bacterial meningitis. Blood, joint, and mucosal membrane studies failed to isolate the causative organism, but his cerebrospinal fluid grew . He was treated with high-dose intravenous ceftriaxone for two weeks with rapid improvement in his mental status and resolution of his joint pains and rash.
淋病奈瑟菌，一种革兰氏阴性球菌，是性活跃人群发病的主要原因。人们认为，从感染的初始部位血行播散的淋病奈瑟菌仅占感染患者的 0.5%至 3%。播散性淋病感染可罕见导致严重的后遗症，如心内膜炎或脑膜炎。本文介绍了一例罕见的播散性淋病感染导致脑膜炎的病例，并发脑积水。该病例的患者最初表现为间歇性多关节痛两年，后来出现皮疹。血液和关节抽吸物的培养均为阴性。尿液核酸扩增试验也为阴性。最初，他因被认为是自身免疫性多关节炎而开始使用类固醇治疗。后来患者出现急性脑病。头部成像显示脑积水。脑脊液分析符合细菌性脑膜炎。血液、关节和黏膜研究未能分离出病原体，但他的脑脊液中培养出淋病奈瑟菌。他接受了两周大剂量静脉注射头孢曲松治疗，精神状态迅速改善，关节疼痛和皮疹消退。
