{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T22:32:23Z","timestamp":1722465143515},"reference-count":25,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,9]]},"abstract":"<jats:p>Two male travelers with histories of gout and hazardous alcohol consumption, presented with a triad of severe culture-positive disseminated gonococcal infection, crystal-positive polyarticular gout, and gonococcal soft tissue collections, following unprotected sexual contact in The Philippines. Both men initially attributed symptoms to gout, since their usual joints were affected, but clinical deterioration occurred with self-administration of anti-inflammatory agents alone. The clinical courses were severe and protracted, requiring aggressive management of infection with prolonged intravenous antimicrobials and repeated surgery, and prolonged anti-inflammatory agents for gout. Joint symptom onset in each case occurred within a week of sexual exposure in conjunction with hazardous alcohol ingestion. We speculate that acute dissemination of infection to previously damaged joints triggered polyarticular gout, with progressive infection, exacerbated by unopposed anti-inflammatory agents and delayed antibiotics. Disseminated gonococcal infection can occur with polyarticular gout and delays in recognition and treatment, including while traveling, can lead to severe disease from both.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0589","type":"journal-article","created":{"date-parts":[[2018,11,20]],"date-time":"2018-11-20T07:06:01Z","timestamp":1542697561000},"page":"209-212","source":"Crossref","is-referenced-by-count":4,"title":["Case Report: Severe Disseminated Gonococcal Infection with Polyarticular Gout: Two Cases in Older Travelers"],"prefix":"10.4269","volume":"100","author":[{"given":"Emma L.","family":"Smith","sequence":"first","affiliation":[{"name":"Division of Medicine, Royal Darwin Hospital, Darwin, Australia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kay E.","family":"Hodgetts","sequence":"additional","affiliation":[{"name":"Division of Medicine, Royal Darwin Hospital, Darwin, Australia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna P.","family":"Ralph","sequence":"additional","affiliation":[{"name":"Division of Medicine, Royal Darwin Hospital, Darwin, Australia;"},{"name":"Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas M.","family":"Anstey","sequence":"additional","affiliation":[{"name":"Division of Medicine, Royal Darwin Hospital, Darwin, Australia;"},{"name":"Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Sex Transm Infect","first-page":"497","article-title":"The epidemiology of gonococcal arthritis in an Indigenous Australian population","volume":"91","author":"Tuttle","year":"2015"},{"key":"b2","series-title":"Sex Transm Dis","first-page":"68","article-title":"Incidence of disseminated gonococcal infection correlated with the presence of AHU auxotype of Neisseria gonorrhoea in a community","volume":"11","author":"Noble","year":"1984"},{"key":"b3","series-title":"Sex Transm Infect","first-page":"613","article-title":"Changing patterns of disseminated gonococcal infection in France: cross-sectional data 2009\u20132011","volume":"89","author":"Belkacem","year":"2013"},{"year":"2018","author":"Klausner","key":"b4"},{"year":"2014","series-title":"Therapeutic Guidelines: Antibiotic, Version 15","author":"Antibiotic Expert Groups","key":"b5"},{"year":"2015","series-title":"Sexually Transmitted Diseases Treatment Guidelines. Gonococcal Infections","author":"Centre for Disease Control","key":"b6"},{"key":"b7","series-title":"Arch Gynecol Obstet","first-page":"185","article-title":"Disseminated gonococcal infection during pregnancy","volume":"273","author":"Phupong","year":"2005"},{"key":"b8","series-title":"J Obstet Gynaecol","first-page":"550","article-title":"Disseminated gonococcal infection in pregnancy","volume":"29","author":"Khoo","year":"2009"},{"key":"b9","series-title":"Clin Rheumatol","first-page":"1351","article-title":"Chronic gonococcal arthritis with C5 deficiency presenting with brief flare-ups: care study and literature review","volume":"33","author":"Davido","year":"2014"},{"key":"b10","series-title":"Semin Arthritis Rheum","first-page":"174","article-title":"Increased risk of neisserial infections in systemic lupus erythematosus","volume":"20","author":"Mitchell","year":"1990"},{"key":"b11","series-title":"Biochem J","first-page":"631","article-title":"Structure and function of the PorB porin from disseminating Neisseria gonorrhoeae","volume":"449","author":"Zeth","year":"2013"},{"key":"b12","series-title":"Infect Immun","first-page":"2358","article-title":"Innate recognition by neutrophil granulocytes differs between Neisseria gonorrhoeae strains causing local or disseminating infections","volume":"81","author":"Roth","year":"2013"},{"key":"b13","series-title":"J Exp Med","first-page":"147","article-title":"Implications of phase variation of a gene (pgtA) encoding a pilin galactosyl transferase in gonococcal pathogenesis","volume":"196","author":"Banerjee","year":"2002"},{"key":"b14","series-title":"Int J STD AIDS","first-page":"273","article-title":"Strains characteristics and antibiotic susceptibility of isolates of Neisseria gonorrhoeae causing disseminated gonococcal infection in Australia. Members of the Australian Gonococcal Surveillance Programme","volume":"3","author":"Tapsall","year":"1992"},{"key":"b15","series-title":"Lancet Infect Dis","first-page":"313","article-title":"Concurrent acute gouty and gonococcal arthritis","volume":"2","author":"Lo","year":"2002"},{"key":"b16","series-title":"Md State Med J","first-page":"598","article-title":"Concomitant appearance of gonorrheal arthritis and gout in monarticular arthritis","volume":"12","author":"Kolodny","year":"1963"},{"key":"b17","series-title":"JAMA","first-page":"12","article-title":"Suppurative myositis and purulent arthritis complicating acute gonorrhoea","volume":"123","author":"Linner","year":"1943"},{"key":"b18","series-title":"JAMA","first-page":"246","article-title":"Gonococcal pyomyositis","volume":"246","author":"Swarts","year":"1981"},{"key":"b19","series-title":"Case Rep Infect Dis","first-page":"9629761","article-title":"A rare case of disseminated pyogenic gonococcal infection in an immunocompetent woman","volume":"2016","author":"Romiopoulos","year":"2016"},{"key":"b20","series-title":"Case Rep Infect Dis","first-page":"790478","article-title":"Gonococcal subcutaneous abscess and pyomyositis: a case report","volume":"2012","author":"Jitmuang","year":"2012"},{"key":"b21","series-title":"Clin Infect Dis","first-page":"861","article-title":"Pyomyositis as the sole manifestation of disseminated gonococcal infection: case report and review","volume":"22","author":"Haugh","year":"1996"},{"key":"b22","series-title":"Clin Infect Dis","first-page":"1384","article-title":"Gonococcal abscess of the obturator internal muscle: use of new diagnostic tools may eliminate the need for surgical intervention","volume":"20","author":"Gurbani","year":"1995"},{"key":"b23","series-title":"Inflammation","first-page":"323","article-title":"Nonsteroidal anti-inflammatory agents inhibit stimulated neutrophil adhesion to endothelium: adenosine dependent and independent mechanisms","volume":"18","author":"Cronstein","year":"1994"},{"key":"b24","series-title":"Mol Pain","first-page":"1744806917743680","article-title":"Colchicine alleviates acute postoperative pain but delays wound repair in mice: roles of neutrophils and macrophages","volume":"13","author":"Sukeishi","year":"2017"},{"key":"b25","series-title":"Epidemiol Infect","first-page":"423","article-title":"An 18 year clinical review of septic arthritis from tropical Australia","volume":"117","author":"Morgan","year":"1996"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/100\/1\/article-p209.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/100\/1\/article-p209.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/100\/1\/article-p209.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T11:49:15Z","timestamp":1722426555000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/100\/1\/article-p209.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,9]]},"references-count":25,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.18-0589","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"type":"print","value":"0002-9637"},{"type":"electronic","value":"1476-1645"}],"subject":[],"published":{"date-parts":[[2019,1,9]]}}}