Irreversible neurological manifestations in undiagnosed disseminated gonococcal infection

Andrea Lin, Justine Julien, Sarah Mauney, James Grogan

Research output: Contribution to journalArticlepeer-review

Abstract

Neisseria gonorrhoeae causes a common sexually transmitted infection with manifestations ranging from asymptomatic to urethritis and pelvic inflammatory disease to disseminated infections including septic arthritis. Serious complications may arise in unrecognised or inappropriately treated infections. We report a young, healthy woman who developed fever and joint pain and was diagnosed with an inflammatory arthritis. After starting immune suppressing treatments, she experienced right wrist drop and progressive muscle atrophy, joint contractures and sensory loss. Electrodiagnostic studies showed patchy, mixed neurogenic and myopathic features. Areas of muscle oedema on extremity MRI led to a right brachioradialis biopsy, which showed only nonspecific changes. Other testing, including lumbar puncture and MRI of the brain/spine was noncontributory. Additional history revealed unprotected intercourse with a new partner prior to symptom onset. Urine gonorrhoeae PCR was positive, and right shoulder arthrocentesis confirmed septic arthritis. After intravenous antibiotic treatment with ceftriaxone, she demonstrated slow, incomplete symptomatic improvement.

Original languageEnglish (US)
Article numbere259762
JournalBMJ case reports
Volume17
Issue number9
DOIs
StatePublished - Sep 26 2024

All Science Journal Classification (ASJC) codes

  • General Medicine

Fingerprint

Dive into the research topics of 'Irreversible neurological manifestations in undiagnosed disseminated gonococcal infection'. Together they form a unique fingerprint.

Cite this