Disseminated Multiple Antibiotic-Resistant Gonococcal Infection: Needed Changes in Antimicrobial Therapy

NEISSERIA GONORRHOEAE usually causes a localized mucosal infection. However, in 1 % to 3 % of cases, the organism disseminates and produces various clinical syn-dromes (1). Two of the commoner manifestations of dis-seminated gonococcal infection are septic arthritis and tenosynovitis (2). In sexually active young persons, dis-seminated gonococcal infection is the most frequent cause of septic arthritis (2). In most studies on dissemi-nated gonococcal infection, only strains of TV. gonor-rhoeae that are very sensitive to penicillin are reported to produce this syndrome (3, 4). The association between clinical virulence of the organism and dissemination may be linked to low antibiotic resistance in specific strains of N. gonorrhoeae, and in-vivo acquisition of resistance in any strain may cause loss of virulence (3)