Clinical manifestations of disseminated infection caused by Neisseria gonorrhoeae are linked to differences in bactericidal reactivity of infecting strains.

Twenty-nine patients with disseminated gonococcal infection were classified into two clinical groups at the time of hospitalization: 13 with suppurative arthritis and 16 with only tenosynovitis, dermatitis, or both. Patients with suppurative arthritis had significantly less tenosynovitis and dermatitis (p less than 0.02). Strains of Neisseria gonorrhoeae isolated from the two groups of patients were each repetitively tested in a bactericidal assay using fresh frozen sera obtained from 10 normal human volunteers. Although strains causing disseminated gonococcal infection in general are serum resistant, those isolated from patients with suppurative arthritis were significantly less resistant (p less than 0.01) than those isolated from patients with only tenosynovitis and dermatitis. Differences in strains as reflected by variation in resistance to normal human sera may cause these strains to produce diverse clinical manifestations.