Disseminated gonococcal infection (DGI) and gonococcal arthritis (GCA): II. Clinical manifestations, diagnosis, complications, treatment, and prevention*

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This is the second part of an integrated review of disseminated gonococcal infection (DGI) and gonococcal arthritis (GCA). It covers clinical manifestations, spectrum of GCA, diagnosis and treatment. These disorders are important since DGI may be the most frequent form of acute arthritis in sexually active younger females, and other selected groups. Although the spectrum of disease is varied, it may be classified into stages and clinical subgroups. N. gonorrhoeae strains causing DGI in the U.S. have been highly sensitive to penicillin. Such findings require revision in beliefs that high-dose intravenous penicillin is needed for effective initial therapy of GCA. Recommended treatment protocols for localized gonorrhea and DGI are reviewed as well as the occurrence and implications for treatment of penicillinase-producing N. gonorrhoeae (PPNG) infection in the U.S.

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    *

    Supported in part by NIAMDD Grant AM-12049.

    3

    Dr. Masi: Professor and Head, Department of Medicine, Peoria School of Medicine.

    4

    Dr. Eisenstein: is the recipient of a Clinical Investigator Award (AM-00686) from the National Institute of Arthritis, Metabolism, and Digestive Diseases of the National Institutes of Health, and is Associate Professor of Medicine, Department of Medicine, UTCHS, Memphis, Tenn.

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