| Subject | Contents |
| Definition | Gonococcemia (disseminated) is a sexually-transmitted disease caused by the bacterium Neisseria gonorrhoeae, which spreads from the initial site of infection through the bloodstream to other parts of the body. |
| Alternative Names | Gonococcal bacteremia |
| Causes, incidence, and risk factors | Gonorrhea is one of the most commonly reported sexually transmitted infectious diseases. It is transmitted through vaginal, oral, and anal intercourse. An infected woman may also transmit the infection to her newborn during childbirth. Gonorrhea in children older than newborns is a sign of sexual abuse. Gonorrhea is most prevalent in those 15 to 29 years old who live in high-density urban areas. Multiple unprotected sexual partners is a risk factor. Disseminated gonococcemia generally follows the primary genital infection by several days to 2 weeks. The infection spreads from the primary site through the bloodstream. Newborns are at increased risk for disseminated gonorrhea. |
| Symptoms | Fever Chills, malaise Joint pain , either single or multiple joints ( knee pain , wrist pain , ankle pain )Joint swelling (knees, wrists, ankles) Skinrash : the classical rash associated with gonococcemia begins as flat pink to red spots (macules) which evolve into raised pus-filled bumps (pustules) Painful tendons of wrist or heels A combination of skin rash and aching swollen tendons -- sometimes known as tenosynovitis-dermatitis syndrome |
| Signs and tests | Blood cultureSkin lesion culture Culture of synovial fluid from joints Urethral discharge cultureCulture from endocervix Throat culture Anal culture |
| Treatment | There are two aspects of treating a sexually transmitted disease, especially one as easily spread as gonorrhea . The first aspect is to cure the affected person. The second is to locate and test all of the other sexual contacts and to treat them to prevent further spread of the disease. That is why mandatory reporting has been instituted and has, until recently, held the number of cases of gonorrhea at a low level. However, the incidence is once again rising. Beginning about the time of the Vietnam War, the United States saw the appearance of penicillin- and tetracycline-resistant strains of gonorrhea. These resistant strains have been increasing over the last few years. Because of this, a new standardized treatment regimen has now been recommended by the Centers for Disease Control (CDC). Instead of the standard penicillin treatment, gonorrhea is now treated by a large number of new and very potent antibiotics, including ceftriaxone and levofloxacin. For gonococcemia, treatment is usually begun with intravenous antibiotics. A follow-up visit after treatment to recheck cultures and confirm the cure of infection is important. |
| Support Groups | |
| Expectations (prognosis) | The outcome is expected to be good when compliance with therapy is maintained. |
| Complications | Gonococcal endocarditis Gonococcal meningitis |
| Calling your health care provider | Call your health care provider if you have symptoms suggestive of disseminated gonococcemia. |
| Prevention | Abstinence is the only sure prevention. Other prevention consists of following safer sexual practices . Monogamous sexual relations with a known disease-free partner is a good means of prevention. Latex condoms help protect against gonorrhea and other sexually transmitted diseases when the status of a partner is unknown or unsafe sexual practices are indulged in. Treatment of all sexual partners of a known infected person is essential to prevent further spread or reinfection. |
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