Question 4 - Gonococcal Infections Question Bank

Gonococcal InfectionsQuestion 4/15

A 37-year-old cisgender man presents to the hospital with pustular skin lesions and tenosynovitis. He does not report any urethral discharge. He is sexually active with men, and has been diagnosed twice before with gonorrhea. He is admitted to the hospital with a suspected diagnosis of disseminated gonococcal infection.

Which one of the following is TRUE regarding disseminated gonococcal infection?

Persons with disseminated gonococcal infection often have minimal or no urogenital symptoms

Perihepatitis is present in more than 50% of persons who develop disseminated gonococcal infection

All persons with disseminated gonococcal infection should have evaluation with echocardiogram to rule out endocarditis

All persons with disseminated gonococcal infection should have evaluation with lumbar puncture to rule out meningitis

This photograph shows cutaneous gonococcal lesion in a person with disseminated <em>Neisseria gonorrhoeae</em> infection.

Figure 1. Disseminated Gonococcal Infection and Cutaneous Lesion

This photograph shows cutaneous gonococcal lesion in a person with disseminated Neisseria gonorrhoeae infection.

Centers for Disease Control and Prevention Public Health Image Library (Dr. Wisner, 1972).

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Question Last Updated
March 29th, 2022

Table 1. 2015 STD Treatment Guidelines: Gonococcal Infections
Treatment of Disseminated Gonococcal Infection (DGI): Arthritis-Dermatitis Syndrome

Recommended for Treatment of Disseminated Gonococcal Infection (DGI): Arthritis-Dermatitis Syndrome

Ceftriaxone

Tradename:Rocephin

1 g IM or IV every 24 hours

Azithromycin

Tradename:Zithromax

1 g orally in a single dose+

Note: The provider can switch to an oral agent guided by antimicrobial susceptibility testing 24–48 hours after substantial clinical improvement, for a total treatment course of at least 7 days. The duration of treatment of DGI has not been systematically studied and should be determined in consultation with an infectious-disease specialist.

Alternative for Treatment of Disseminated Gonococcal Infection (DGI): Arthritis-Dermatitis Syndrome

Cefotaxime

Tradename:Claforan

1 g IV every 8 hours

Azithromycin

Tradename:Zithromax

1 g orally in a single dose+

Alternative for Treatment of Disseminated Gonococcal Infection (DGI): Arthritis-Dermatitis Syndrome

Ceftizoxime

Tradename:Cefizox

1 g IV every 8 hours

Azithromycin

Tradename:Zithromax

1 g orally in a single dose+

Source: Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. Gonococcal infections. MMWR Recomm Rep. 2015;64(No. RR-3):1-137. [2015 STD Treatment Guidelines]

Table 2. 2015 STD Treatment Guidelines: Gonococcal Infections
Treatment of Disseminated Gonococcal Infection: Meningitis and Endocarditis

Recommended for Treatment of Disseminated Gonococcal Infection: Meningitis and Endocarditis

Ceftriaxone

Tradename:Rocephin

1–2 g IV every 12–24 hours

Azithromycin

Tradename:Zithromax

1 g orally in a single dose+

Note: Therapy for meningitis should be continued with recommended parenteral therapy for 10–14 days. Parenteral antimicrobial therapy for endocarditis should be administered for at least 4 weeks. The duration of treatment of DGI has not been systematically studied and should be determined in consultation with an infectious-disease specialist.

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Gonococcal InfectionsQuestion 4/15

Questions in Topic

Which one of the following is TRUE regarding disseminated gonococcal infection?

Table 1. 2015 STD Treatment Guidelines: Gonococcal Infections
Treatment of Disseminated Gonococcal Infection (DGI): Arthritis-Dermatitis Syndrome

Ceftriaxone

Azithromycin

Cefotaxime

Azithromycin

Ceftizoxime

Azithromycin

Table 2. 2015 STD Treatment Guidelines: Gonococcal Infections
Treatment of Disseminated Gonococcal Infection: Meningitis and Endocarditis

Ceftriaxone

Azithromycin

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Gonococcal InfectionsQuestion 4/15

Questions in Topic

Which one of the following is TRUE regarding disseminated gonococcal infection?

Table 1. 2015 STD Treatment Guidelines: Gonococcal InfectionsTreatment of Disseminated Gonococcal Infection (DGI): Arthritis-Dermatitis Syndrome

Ceftriaxone

Azithromycin

Cefotaxime

Azithromycin

Ceftizoxime

Azithromycin

Table 2. 2015 STD Treatment Guidelines: Gonococcal InfectionsTreatment of Disseminated Gonococcal Infection: Meningitis and Endocarditis

Ceftriaxone

Azithromycin

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Table 1. 2015 STD Treatment Guidelines: Gonococcal Infections
Treatment of Disseminated Gonococcal Infection (DGI): Arthritis-Dermatitis Syndrome

Table 2. 2015 STD Treatment Guidelines: Gonococcal Infections
Treatment of Disseminated Gonococcal Infection: Meningitis and Endocarditis