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一名老年患者的淋病性化脓性关节炎累及双侧手腕和手部

Gonococcal Septic Arthritis Involving Bilateral Wrists and Hands in an Elderly Patient.

作者信息

Willett David K, Siau Evan

机构信息

Medicine, NYU Grossman School of Medicine, New York, USA.

出版信息

Cureus. 2025 May 29;17(5):e85018. doi: 10.7759/cureus.85018. eCollection 2025 May.

Abstract

is a Gram-negative intracellular diplococcus that is commonly spread via sexual activity. The bacteremic spread of can lead to an uncommon complication called disseminated gonococcal infection (DGI). DGI has a range of clinical presentations, some of which are vague and nonspecific, including polyarthralgias, isolated septic arthritis, and systemic symptoms. Septic arthritis is a painful joint infection that can lead to inflammation, swelling, and limited mobility. We discuss a case of a male in his mid-70s with sudden bilateral wrist pain and swelling due to a DGI. The diagnosis was complicated by multiple unsuccessful arthrocentesis attempts ("dry taps") but was eventually confirmed by tissue culture, and the patient was treated with ceftriaxone. This report highlights a unique clinical presentation of DGI, the complex nature of its diagnosis, and the importance of thorough history taking.

摘要

是一种革兰氏阴性细胞内双球菌,通常通过性活动传播。该菌的血行播散可导致一种罕见的并发症,称为播散性淋球菌感染(DGI)。DGI有一系列临床表现,其中一些表现模糊且不具特异性,包括多关节痛、孤立性化脓性关节炎和全身症状。化脓性关节炎是一种疼痛的关节感染,可导致炎症、肿胀和活动受限。我们讨论一例70多岁男性因DGI出现突发双侧腕关节疼痛和肿胀的病例。诊断因多次关节穿刺尝试失败(“干抽”)而复杂化,但最终通过组织培养得以确诊,患者接受了头孢曲松治疗。本报告强调了DGI独特的临床表现、其诊断的复杂性以及全面病史采集的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2460/12205482/e9fd1999501d/cureus-0017-00000085018-i01.jpg

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