Back issues No.2 - 1997 / Case Report  

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Disseminated Gonococcal Infection
Hon-Ru Yu, Chin-Fang Lu, Chi-Chin Shih
Dermatol Sinica 15: 109-114, 1997

Disseminated gonococcal infection (DGI) is a very rare disease in Taiwan. We report a 43-year-old femal patient who initially presented with fever and multiple joint pain. Two days later, multiple discrete papules, pustules with erythematous base were found. Skin biopsy revealed acute suppurative inflammation with subcorneal abscess formation, septic vasculitis with microthrombus formation. Gram negative diplococci were demonstrated by Gram stain. Culture was performed from vaginal discharge revealed Neisseria gonorrhoeae which was resistant to penicillin and minocycline, but sensitive to erythromycin. Gram negative diplococci were also found in the direct smear from vaginal discharge. The blood culture yielded no growth. The patient received intravenous injection of aqueous penicillin for 7 days without clinical improvement. Therapy was shifted to erythromycin (2gm/day) orally for 10 days according to the bacterial sensitivity test. The arthralgia improved dramatically within 2 days, and the skin eruptions cleared within 5 days after erythromycin therapy. We herein report the typical DGI case, and propose the pathogenesis of skin manifestation in disseminated gonococcal infection.

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