{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:43:39Z","timestamp":1791985419621,"version":"4.4.0"},"reference-count":11,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,1,14]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>\n                  <jats:italic>Neisseria gonorrhoeae<\/jats:italic> is the causative organism in 0.6%\u20131.2% of septic arthritis cases in North America and Europe, and classically presents as migratory polyarthralgias and tenosynovitis, with later development of septic oligoarthritis. In men, urine gonorrhoea nucleic amplification testing (NAAT) is the preferred diagnostic test, as its sensitivity surpasses that of joint and blood culture in disseminated infections. We present a case of a previously healthy man who presented with septic arthritis of the wrist. He denied any sexual activity in the previous year. Urine gonorrhoea NAAT and cultures were negative. However, <jats:italic>N. gonorrhoeae<\/jats:italic> was later identified via 16s PCR of the patient\u2019s synovial fluid, leading to a delayed diagnosis of gonococcal arthritis. In patients with septic arthritis, gonococcal infection should remain on the differential despite reported sexual history and negative urine NAAT. Clinicians should continue to follow cultures and provide antibiotic coverage until a causative organism is identified.<\/jats:p>","DOI":"10.1136\/bcr-2019-231823","type":"journal-article","created":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T14:34:17Z","timestamp":1580826857000},"page":"e231823","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Septic arthritis in a previously healthy man with pan-negative infectious and rheumatologic work-up"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8613-1973","authenticated-orcid":false,"given":"Ann Andee","family":"Wang","sequence":"first","affiliation":[{"name":"Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elyse Anna","family":"Linson","sequence":"additional","affiliation":[{"name":"Internal Medicine, Northwestern Memorial Hospital, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,2,3]]},"reference":[{"key":"2025082722442135000_13.2.e231823.1","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.idc.2017.01.001","article-title":"Septic arthritis of native joints","volume":"31","author":"Ross","year":"2017","journal-title":"Infect Dis Clin North Am"},{"key":"2025082722442135000_13.2.e231823.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1521-6942(02)00125-0"},{"key":"2025082722442135000_13.2.e231823.3","first-page":"653","article-title":"Approach to septic arthritis","volume":"84","author":"Horowitz","year":"2011","journal-title":"Am Fam Physician"},{"key":"2025082722442135000_13.2.e231823.4","first-page":"1","article-title":"Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae--2014","volume":"63","year":"2014","journal-title":"MMWR Recomm Rep"},{"key":"2025082722442135000_13.2.e231823.5","first-page":"184","article-title":"Primary meningococcal septic arthritis of the knee by Neisseria meningitidis serotype Y","volume":"63","author":"Akparanta","year":"2014","journal-title":"West Indian Med J"},{"key":"2025082722442135000_13.2.e231823.6","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000007573","article-title":"Arthritis secondary to meningococcal disease: a case series of 7 patients","volume":"96","author":"Masson-Behar","year":"2017","journal-title":"Medicine"},{"key":"2025082722442135000_13.2.e231823.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.13.1478"},{"key":"2025082722442135000_13.2.e231823.8","doi-asserted-by":"crossref","first-page":"884","DOI":"10.7326\/M14-1022","article-title":"Screening for gonorrhea and Chlamydia: a systematic review for the U.S. preventive services Task force","volume":"161","author":"Zakher","year":"2014","journal-title":"Ann Intern Med"},{"key":"2025082722442135000_13.2.e231823.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0211682","article-title":"Prevalence and factors associated with gonorrhea infection with respect to anatomic distributions among men who have sex with men","volume":"14","author":"Budkaew","year":"2019","journal-title":"PLoS One"},{"key":"2025082722442135000_13.2.e231823.10","doi-asserted-by":"publisher","DOI":"10.1177\/0956462415585253"},{"key":"2025082722442135000_13.2.e231823.11","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.93.20.11109"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-231823","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:44:27Z","timestamp":1756359867000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-231823"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2,3]]},"published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1136\/bcr-2019-231823"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-231823","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2]]}}}