DDx
Diagnostic Considerations
In the pediatric population, the diagnosis of gonococcal arthritis must be considered if the patient is sexually active or abused. In the geriatric population, gonococcal arthritis is uncommon but should be considered if suggested by the patient’s sexual history.
In addition to the conditions listed in the differential diagnosis, other problems to be considered include the following:
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Bacterial endocarditis
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Parvovirus infection
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Gout (may mimic septic arthritis and rarely occurs with gonococcal arthritis)
Infectious causes of fever and purpuric skin lesions include the following:
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Rickettsial infections
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Staphylococcal bacteremia
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Coxsackievirus infection
Noninfectious causes of fever and purpuric skin lesions include the following:
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Systemic lupus erythematosus with small-vessel vasculitis
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Rheumatoid arthritis with small-vessel vasculitis
Mistaking gonococcal arthritis for a noninfectious condition that requires immunosuppressive therapy may result in worsening of the infection. [13]
Differential Diagnoses
Media Gallery
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Synovial joint.
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The lesion on this patient's heel was due to the systemic dissemination of the N gonorrhoeae bacteria.
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The foot of this patient is swollen due to gonococcal arthritis.
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This patient presented with cutaneous foot lesions that were diagnosed as a disseminated gonococcal infection.
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