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Changing patterns of disseminated gonococcal infection in France: cross-sectional data 2009–2011
  1. Anna Belkacem1,
  2. Eric Caumes2,
  3. Jocelyne Ouanich3,4,
  4. Vincent Jarlier5,
  5. Sophie Dellion1,
  6. Benoit Cazenave1,
  7. Régis Goursaud6,
  8. Flore Lacassin6,
  9. Jacques Breuil3,4,
  10. Olivier Patey1,
  11. for the working group FRA-DGI
  1. 1Department of Infectious and Tropical Diseases, Centre Hospitalier Intercommunal, Villeneuve Saint Georges, France
  2. 2Department of Infectious and Tropical Diseases, Hopital Universitaire Pitié-Salpêtrière, University Pierre et Marie Curie, Paris, France
  3. 3Department of Microbiology, Centre Hospitalier Intercommunal, Villeneuve Saint Georges, France
  4. 4College of Bacteriology, Virology and Hygiene Hospital of Paris, Paris, France
  5. 5Department of Microbiology, Hopital Universitaire Pitié-Salpêtrière, University Pierre et Marie Curie, Paris, France
  6. 6Department of Internal Medicine, Centre Hospitalier Magenta, Nouvelle Calédonie
  1. Correspondence to Anna Belkacem, Department of Infectious and Tropical Disease, Hospital Villeneuve Saint Georges, 40 Allée de la Source, Villeneuve Saint Georges 94 195, France; anna_belkacem{at}hotmail.com

Abstract

Objectives Disseminated gonococcal infections (DGIs) are rare. We describe the characteristics of DGIs in France.

Methods This is a 3-year retrospective analysis of DGI cases collected through two networks of microbiologists and infectious disease specialists in France between 2009 and 2011. DGI was defined either by the isolation of Neisseria gonorrhoeae from blood and synovial fluid or by the existence of a clinical syndrome consistent with DGI and the isolation of N gonorrhoeae from any site. We describe the epidemiological, clinical and microbiological characteristics and outcomes of DGIs.

Results 21 patients (9 women, 12 men; 18–62 years old) were diagnosed with DGI. The number of DGI cases increased between 2009 and 2011. Two men who had sex with men were coinfected with HIV. We found 28 extragenital locations, including arthritis (14 cases), tenosynovitis (7), skin lesions (4), endocarditis (1), prostatitis (1) and pelvic inflammatory disease (1). Genital signs were present in five patients. The diagnosis was confirmed by cultures in 20 patients—blood (4), synovial fluid (11), genital (3), throat (1), urine (1)—and by molecular biology on a pharyngeal swab in 1 patient. Seven cases were resistant to fluoroquinolones. The patients were treated with ceftriaxone, associated with corticosteroids (two cases) and surgery (six cases). Four patients had joint sequelae.

Conclusions DGIs are increasing. Men seem to be at higher risk than women. Joint involvement was common. Microbiological diagnosis was based on culture, however molecular biology using pharyngeal swabs was helpful when cultures were negative.

  • NEISSERIA GONORRHOEA
  • GONOCOCCI
  • DERMATOLOGY
  • EPIDEMIOLOGY (CLINICAL)

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