40 year old female, who has multiple sexual paners presented with fever, rash and aicular symptoms. Migratory ahritis and tenosynovitis of knees, hands, wrists, feet and ankles noticed during clinical examination. Synol fluid leukocyte count was 12,000/ml and culture was sterile. The patient has been successfully treated with injection ceftriaxone 1 g Q24 hours for 7 days. What was the diagnosis in this setting?
Gonococcal ahritis has accounted for up to 70% of episodes of infectious ahritis in persons True gonococcal septic ahritis is less common than the DGI syndrome and always follows disseminated gonococcal ahritis, which is unrecognized in one-third of patients. A single joint such as the hip, knee, ankle, or wrist is usually involved. Synol fluid, which contains >50,000 leukocytes/L. Initial treatment consists of ceftriaxone (1 g IV or IM every 24 h). Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 2845
Ahritis due to Pseudomona aeruginosa
Disseminated gonococcal infection
Gonococcal septic ahritis
Syphilitic ahritis