{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:03:45Z","timestamp":1763643825097,"version":"3.40.5"},"reference-count":14,"publisher":"Akademiai Kiado Zrt.","issue":"1","license":[{"start":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["EuJMI"],"published-print":{"date-parts":[[2023,7,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We report on a 38-year-old male patient with disseminated gonococcal infection. Preceding the discharge diagnosis, the patient was treated regarding rheumatoid arthritis, which resulted in the deterioration of the patient's medical condition due to the immunomodulatory nature of the applied medication. The causative agent was identified by culturing joint puncture fluid inoculated into blood culture vials. Primary infection with the pathogen could not be pinpointed in terms of time, but on further questioning, the patient reported intimate contacts with a number of different male partners, which may be assumed to have included the infection source. The case hereby demonstrates the impact that an early misdiagnosis and a limited anamnesis can have on the progress of a patient's disease. Furthermore, this case has helped us to propose possible improvements in both clinical and microbiological diagnostic approaches.<\/jats:p>","DOI":"10.1556\/1886.2023.00004","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T13:27:36Z","timestamp":1681910856000},"page":"24-28","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":3,"title":["Case report: Disseminated gonococcal infection, a story of camouflage and deceit"],"prefix":"10.1556","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6052-5189","authenticated-orcid":true,"given":"Niklas","family":"Klein","sequence":"first","affiliation":[{"name":"Department of Microbiology and Hospital Hygiene, Bundeswehr Central Hospital Koblenz, 56070, Koblenz, Germany"},{"name":"Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, 53127, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lioba","family":"B\u00fcrvenich","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, 53127, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"B\u00fcchler","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, 53127, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"B1","series-title":"Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021","author":"World Health Organization","year":"2021","unstructured":"World Health Organization. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Geneva (Switzerland): World Health Organization; 2021."},{"article-title":"Berlin (Germany): Robert Koch-Institut; as of 2020 Nov 17. Gonorrh\u00f6 (Tripper), RKI-Ratgeber [Gonorrhea; RKI-Guidebook]; as of 2020 Jul 07 [cited 2022 Oct 21]; [about 2 screens]","author":"Robert Koch-Institut [Internet]","key":"B2","unstructured":"Robert Koch-Institut [Internet]. Berlin (Germany): Robert Koch-Institut; as of 2020 Nov 17. Gonorrh\u00f6 (Tripper), RKI-Ratgeber [Gonorrhea; RKI-Guidebook]; as of 2020 Jul 07 [cited 2022 Oct 21]; [about 2 screens]. Available from: https:\/\/www.rki.de\/DE\/Content\/Infekt\/EpidBull\/Merkblaetter\/Ratgeber_Gonorrhoe.html."},{"key":"B3","series-title":"J Clin Microbiol","article-title":"The brief case: disseminated Neisseria gonorrhoeae in an 18-year-old female","volume":"56","author":"Burns JE","year":"2018","unstructured":"Burns JE, Graf EH. The brief case: disseminated Neisseria gonorrhoeae in an 18-year-old female. J Clin Microbiol 2018;56:e00932\u201317."},{"issue":"3","key":"B4","series-title":"Gynecol Obstet","first-page":"597","article-title":"Disseminated gonococcal infection in women","volume":"119","author":"Bleich AT","year":"2012","unstructured":"Bleich AT, Sheffield JS, Wendel GD, Sigman A, Cunningham FG. Disseminated gonococcal infection in women. Gynecol Obstet 2012;119(3):597\u2013602."},{"key":"B5","series-title":"Intern Med","first-page":"2039","article-title":"Disseminated gonococcal infection in Japan: a case report and literature Review","volume":"50","author":"Suzaki A","year":"2011","unstructured":"Suzaki A, Hayashi K, Kosuge K, Soma M, Hayakawa S. Disseminated gonococcal infection in Japan: a case report and literature Review. Intern Med 2011;50:2039\u20132043."},{"key":"B6","series-title":"Sex Health","first-page":"401","article-title":"Epidemiology of gonorrhoea: a global perspective","volume":"16","author":"Kirkcaldy RD","year":"2019","unstructured":"Kirkcaldy RD, Weston E, Segurado AC, Hughes G. Epidemiology of gonorrhoea: a global perspective. Sex Health 2019;16:401."},{"key":"B7","series-title":"Arch Rheumatol","first-page":"387","article-title":"A young male with arthritis and skin lesions","volume":"33","author":"Hoving V","year":"2018","unstructured":"Hoving V, Borg EJT. A young male with arthritis and skin lesions. Arch Rheumatol 2018;33:387\u2013388."},{"key":"B8","series-title":"J Infect Dev Ctries","first-page":"1222","article-title":"The rarity of gonococcal arthritis in association with HIV infection","volume":"8","author":"Maharaj R","year":"2014","unstructured":"Maharaj R, Mody GM. The rarity of gonococcal arthritis in association with HIV infection. J Infect Dev Ctries 2014;8:1222\u20131227."},{"key":"B9","series-title":"J Clin Pathol","first-page":"90","article-title":"Disseminated gonococcal infection presenting as vasculitis: a case report","volume":"60","author":"Jain S","year":"2007","unstructured":"Jain S, Win HN, Chalam V, Yee L. Disseminated gonococcal infection presenting as vasculitis: a case report. J Clin Pathol 2007;60:90\u201391."},{"key":"B10","series-title":"IDCases","article-title":"A case of purulent gonococcal arthritis","volume":"19","author":"Vidaurrazaga MM","year":"2020","unstructured":"Vidaurrazaga MM, Perlman DC. A case of purulent gonococcal arthritis. IDCases 2020;19:e00662."},{"issue":"10","key":"B11","series-title":"Can Med Assoc J","first-page":"1188","article-title":"Disseminated gonococcal infection","volume":"126","author":"Bowmer MI","year":"1982","unstructured":"Bowmer MI, Leggat I, Barrowman JA. Disseminated gonococcal infection. Can Med Assoc J 1982;126(10):1188\u20131190."},{"article-title":"Druid Hills (United States): Centers for disease Control and prevention; [accessed 2023 Mar 16]. Sexually transmitted infections treatment Guidelines, 2021 \u2013 Gonococcal infections among adolescents and adults; as of 2021 Sep 21 [cited 2023 Mar 16]; [About 1 screen]","author":"Centers for Disease Control and Prevention [Internet]","key":"B12","unstructured":"Centers for Disease Control and Prevention [Internet]. Druid Hills (United States): Centers for disease Control and prevention; [accessed 2023 Mar 16]. Sexually transmitted infections treatment Guidelines, 2021 \u2013 Gonococcal infections among adolescents and adults; as of 2021 Sep 21 [cited 2023 Mar 16]; [About 1 screen]. Available from: https:\/\/www.cdc.gov\/std\/treatment-guidelines\/gonorrhea-adults.htm."},{"key":"B13","series-title":"Clin Microbiol Rev","first-page":"444","article-title":"Update on detection\u00a0of\u00a0bacteremia and fungemia","volume":"10","author":"Reimer LG","year":"1997","unstructured":"Reimer LG, Wilson ML, Weinstein MP. Update on detection\u00a0of\u00a0bacteremia and fungemia. Clin Microbiol Rev 1997;10, 444\u2013465."},{"key":"bib14","series-title":"21]; [about 4 screens]","article-title":"Breakpoint tables for interpretation of MICs and zone diameters. Version 12.0, 2022 [Internet]. [Place unknown]. European Committee on Antimicrobial Susceptibility Testing","author":"European Committee on Antimicrobial Susceptibility Testing.","year":"Oct","unstructured":"European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 12.0, 2022 [Internet]. [Place unknown]. 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