{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:06:23Z","timestamp":1788998783006,"version":"build-2803163510"},"reference-count":26,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,2]]},"abstract":"<jats:p>\n                    The \u201cTop End\u201d of Australia is presently experiencing a gonorrhea epidemic. Gonococcal infection is usually limited to mucosal tissues but can lead to disseminated gonococcal infection (DGI), joint destruction, and severe sepsis. This study aimed to explore the epidemiology, presentation, management, and health-care impact of DGI in the Top End of the Northern Territory. Health records of patients diagnosed with proven, probable, or possible DGI between January 2010 and September 2018 were analyzed retrospectively. One hundred six cases of DGI were identified. Ninety-four patients (88.7%) were Indigenous Australian. The incidence of proven and probable DGI in the Indigenous population was 27.1 per 100,000 person-years, compared with 7.1 in the Top End population overall. Of 7,540 laboratory-proven gonococcal notifications, 1.3% (\n                    <jats:italic>n<\/jats:italic>\n                    = 97) were complicated by DGI. The highest incidence was in the 15\u201319-year age-group. Thirteen cases (12.3%) occurred in patients younger than 15 years. High rates of comorbid alcohol misuse, diabetes, systemic lupus erythematosus, rheumatic fever, and complement deficiency were observed. The \u201cclassic triad\u201d of tenosynovitis, dermatitis, and polyarthralgia was rare. Ninety-four patients (88.7%) presented with purulent arthritis. Disseminated gonococcal infection was estimated to cause at least 10.0% of nonpenetrating septic arthritis in the Top End and 1,234 days of hospitalization during the study period. DGI is an important cause of morbidity in the Top End, particularly in the young, remote Indigenous Australian population. Clinical presentation varies from classical teaching. Urgent action in the health and community sector is required, particularly for at-risk populations, to prevent further debilitating and costly complications of gonococcal infection.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.19-0288","type":"journal-article","created":{"date-parts":[[2019,8,6]],"date-time":"2019-08-06T03:00:37Z","timestamp":1565060437000},"page":"753-760","source":"Crossref","is-referenced-by-count":31,"title":["Characteristics and Impact of Disseminated Gonococcal Infection in the \u201cTop End\u201d of Australia"],"prefix":"10.4269","volume":"101","author":[{"given":"Johanna M.","family":"Birrell","sequence":"first","affiliation":[{"name":"Northern Territory Centre for Disease Control, Darwin, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoji","family":"Gunathilake","sequence":"additional","affiliation":[{"name":"Northern Territory Centre for Disease Control, Darwin, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Singleton","sequence":"additional","affiliation":[{"name":"Northern Territory Centre for Disease Control, Darwin, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shellee","family":"Williams","sequence":"additional","affiliation":[{"name":"Northern Territory Centre for Disease Control, Darwin, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicki","family":"Krause","sequence":"additional","affiliation":[{"name":"Northern Territory Centre for Disease Control, Darwin, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"HIV, Viral Hepatitis and Sexually Transmissible Infections in Australia: Annual Surveillance Report 2018","author":"Kirby Institute","year":"2018"},{"key":"b2","series-title":"Surveillance Update for Notifiable Sexually Transmitted Infections and Blood-Borne Viruses in the Northern Territory (NT)","first-page":"9","author":"Sexual Health & Blood Borne Virus Unit (SHBBVU)","year":"2018"},{"key":"b3","series-title":"Best Pract Res Clin Rheumatol","first-page":"201","article-title":"Gonococcal arthritis","volume":"17","author":"Bardin","year":"2003"},{"key":"b4","series-title":"Br Med J","first-page":"482","article-title":"Septic gonococcal dermatitis","volume":"1","author":"Barr","year":"1971"},{"key":"b5","series-title":"Sexually Transmitted Diseases","author":"Holmes","year":"2008"},{"key":"b6","series-title":"Disseminated Gonococcal Infection","author":"Klausner","year":"2019"},{"key":"b7","series-title":"Infect Dis Clin North Am","first-page":"853","article-title":"Gonococcal arthritis (disseminated gonococcal infection)","volume":"19","author":"Rice","year":"2005"},{"key":"b8","series-title":"Clin Infect Dis","first-page":"E92","article-title":"Gonococcemia associated with fatal septic shock","volume":"32","author":"Thiery","year":"2001"},{"key":"b9","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":"b10","series-title":"Vaccines (Basel)","first-page":"1","article-title":"Effectiveness of a group B outer membrane vesicle Meningococcal vaccine in preventing hospitalization from gonorrhea in New Zealand: a retrospective cohort study","volume":"7","author":"Paynter","year":"2019"},{"key":"b11","series-title":"2016 Census QuickStats. Canberra: AIHW","author":"Australian Institute of Health and Welfare (AIHW)","year":"2016"},{"key":"b12","series-title":"2011 census QuickStats. Canberra: AIHW","author":"AIHW","year":"2011"},{"key":"b13","series-title":"Health Library Services ePublications","author":"Centre for Disease Control, Northern Territory Government","year":"2018"},{"key":"b14","series-title":"Am J Trop Med Hyg","first-page":"209","article-title":"Case report: severe disseminated gonococcal infection with polyarticular gout: two cases in older travelers","volume":"100","author":"Smith","year":"2019"},{"key":"b15","series-title":"Australian Guideline for Prevention, Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease","author":"RHDAustralia (ARF\/RHD writing group), National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand","year":"2012"},{"key":"b16","series-title":"Australian Aboriginal and Torres Strait Islander Health Survey: First results, Australia, 2012\u20132013","author":"Australian Bureau of Statistics","year":"2013"},{"key":"b17","series-title":"Aboriginal and Torres Strait Islander Health Performance Framework 2017: Supplementary Online Tables","author":"AIHW","year":"2017"},{"key":"b18","series-title":"Intern Med J","first-page":"227","article-title":"Focus on systemic lupus erythematosus in Indigenous Australians: towards a better understanding of autoimmune diseases","volume":"43","author":"Vincent","year":"2013"},{"key":"b19","series-title":"Aust N Z J Med","first-page":"646","article-title":"Systemic lupus erythematosus in Australian aborigines: high prevalence, morbidity and mortality","volume":"23","author":"Anstey","year":"1993"},{"key":"b20","series-title":"NT Guidelines for the Management of Sexually Transmitted Infections in the Primary Health Care Setting","author":"SHBBVU","year":"2016"},{"key":"b21","series-title":"South Med J","first-page":"284","article-title":"Acute human immunodeficiency virus infection presenting as disseminated gonococcal infection","volume":"96","author":"Amir","year":"2003"},{"key":"b22","series-title":"Medicine (Baltimore)","first-page":"243","article-title":"Complement deficiency states and infection: epidemiology, pathogenesis and consequences of neisserial and other infections in an immune deficiency","volume":"63","author":"Ross","year":"1984"},{"key":"b23","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":"b24","series-title":"Am J Trop Med Hyg","first-page":"1643","article-title":"Acute post-streptococcal glomerulonephritis in the northern territory of Australia: a review of data from 2009 to 2016 and comparison with the literature","volume":"99","author":"Chaturvedi","year":"2018"},{"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"},{"key":"b26","series-title":"Bone and Joint Infections. Version 15","first-page":"365","author":"Therapeutic Guidelines","year":"2014"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/101\/4\/article-p753.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/101\/4\/article-p753.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/101\/4\/article-p753.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T17:33:15Z","timestamp":1722447195000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/101\/4\/article-p753.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,2]]},"references-count":26,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.19-0288","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,2]]}}}