Gonococcal arthritis: case series of 58 hospital cases.

Autor: Moussiegt A; Internal Medicine Department, CHU Nord, La Réunion, France., François C; Internal Medicine and Infectious Disease Department, CH Ouest, La Réunion, France., Belmonte O; Bacteriology Department, CHU Nord, La Réunion, France., Jaubert J; Bacteriology Department, CHU Sud, La Réunion, France., Traversier N; Bacteriology Department, CHU Nord, La Réunion, France., Picot S; Bacteriology Department, CHU Sud, La Réunion, France., Josse F; Internal Medicine Department, GH Est, La Réunion, France., Guillot X; Internal Medicine Department, CHU Nord, La Réunion, France., Poubeau P; Department of Infectious Disease, Internal Medicine and Dermatology, CHU Sud, La Réunion, France., Moiton MP; Infectious Disease Department, CHU Nord, La Réunion, France., Bertolotti A; Department of Infectious Disease, Internal Medicine and Dermatology, CHU Sud, La Réunion, France.; Inserm CIC 1410, Saint-Pierre, Réunion Island, France., Raffray L; Internal Medicine Department, CHU Nord, La Réunion, France. loic.raffray@chu-reunion.fr.; Université de La Réunion, UMR PIMIT, CHU de La RéunionUnité Mixte Processus Infectieux en Milieu Insulaire Tropical (PIMIT), Plateforme Technologique CYROI, INSERM U1187, IRD 249 Sainte-Clotilde, CNRS 9192, La Réunion, France. loic.raffray@chu-reunion.fr.; Service de Médecine Interne, CHU Félix Guyon, Allée des Topazes, 97400, Saint Denis, France. loic.raffray@chu-reunion.fr.
Jazyk: angličtina
Zdroj: Clinical rheumatology [Clin Rheumatol] 2022 Sep; Vol. 41 (9), pp. 2855-2862. Date of Electronic Publication: 2022 May 20.
DOI: 10.1007/s10067-022-06208-w
Abstrakt: Objectives: Extra-genital manifestations of gonococcal infection are rare (0.5-3%). Among them, gonococcal arthritis (GA) is the most frequent, accounting for 30-90% of disseminated infections. Our study aimed to describe all hospital cases of GA in Reunion Island, a French overseas territory.
Methods: We conducted a retrospective, multicentric, observational study of all cases of certain, probable or possible GA from 2008 to 2020.
Results: We identified 58 cases of GA, mostly certain cases (n = 48). Sex ratio was balanced, but men were older than women (51 vs 27 years, p < 0.001). A total of 41% had travelled abroad during the previous 3 months, mostly in Madagascar or South-East Asia. The most frequently infected joint was the knee, followed by ankle, wrist and fingers or carpal joints. Only 16% of cases had genital symptoms, but 50% had another extra-genital manifestation, mainly skin lesions (40%). Positivity rate of joint puncture was 91%, with a purulent liquid. Only 58% had a positive culture, and 33% had only a positive PCR. There was no 3GC-resistant strain. In comparison with gonococcal infection without arthritis, patients were older and had fewer genital but more extra-genital symptoms. On discharge 60% had persistent articular symptoms. GA represented 18% of all hospitalised septic arthritis cases with microbial identification in 2019.
Conclusions: GA is rare but it is important to make an early diagnosis and treat promptly, as joint destruction may be important, leading to persistent symptoms after discharge. PCR use in joint puncture is useful in cases with negative culture.
(© 2022. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)
Databáze: MEDLINE
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