Two patients died, but the reasons are not indicated.Īntimicrobial susceptibility data were available for 47 isolates and none were resistant to ceftriaxone, cefixime, or azithromycin, while resistance to penicillin, tetracyclines, and ciprofloxacin was detected in 9%, 16%, and 43%, respectively. Of the total, 102 (92%) were hospitalized and 47 (46%) of 103 underwent a surgical procedure. Two patients had osteomyelitis and one had a hepatic abscess. Blood cultures were positive in 40/97 (41%) samples. Petechial and/or pustular skin lesions were present in 13 (12%) cases.īacteremia was detected in one-third, and five cases (5%) had endocarditis. Synovial fluid cultures were positive in 47/69 (68%). Fever and polyarthralgia occurred in approximately one-third, and 59 (53%) were considered to have septic arthritis and one-fifth had tenosynovitis. Urogenital, pharyngeal, and rectal symptoms were absent in the majority. The median interval from symptom onset to presentation was three days (interquartile range, 1-7). Two had previously had an episode of DGI, but none were recorded as having complement deficiency and none were receiving eculizumab. Diabetes mellitus was reported in 13 (12%), human immunodeficiency virus infection was reported in nine (8%), chronic hepatitis C virus infection was reported in six (5%), six (5%) were receiving immunosuppressive therapy, and two were pregnant. Almost one-fourth had experienced homelessness in the previous 12 months. Illicit drug use, mostly methamphetamine, was reported in 36 of the 94 (36%) cases for which the information was available. More complete information was available for 111 cases. The mean age of the cases was 40 years, but it was significantly lower in cisgender males (36 years), who accounted for half the cases, than in cisgender females (45 years). The estimated incidence was 0.47 DGI cases per 100,000 population. Of the 53,338 cases of gonorrhea reported, 149 (0.24%) had DGI, 115 of which were confirmed and 34 were probable. This area includes all of California except Los Angeles and San Francisco, which have separate surveillance systems. T ang and colleagues examined all cases of disseminated gonococcal infection (DGI) reported to the California Department of Public Health (CDPH) during July 1, 2020, to July 31, 2021, from the California Project Area. Characterizing the rise of disseminated gonococcal infections in California, July 2020-July 2021. SOURCE: Tang ET, Johnson KA, Alvarado L, et al. SYNOPSIS: Only 0.24% of patients with gonorrhea had disseminated infection, with septic arthritis occurring in approximately one-half. Clinical Professor of Medicine, Stanford University
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