TAILIEUCHUNG - Chapter 137. Gonococcal Infections (Part 6)

The clinical manifestations of DGI have sometimes been classified into two stages: a bacteremic stage, which is less common today, and a joint-localized stage with suppurative arthritis. A clear-cut progression usually is not evident. Patients in the bacteremic stage have higher temperatures, and their fever is more frequently accompanied by chills. Painful joints are common and often occur in conjunction with tenosynovitis and skin lesions. Polyarthralgias usually include the knees, elbows, and more distal joints; the axial skeleton is generally spared. Skin lesions are seen in ~75% of patients and include papules and pustules, often with a hemorrhagic component. | Chapter 137. Gonococcal Infections Part 6 The clinical manifestations of DGI have sometimes been classified into two stages a bacteremic stage which is less common today and a joint-localized stage with suppurative arthritis. A clear-cut progression usually is not evident. Patients in the bacteremic stage have higher temperatures and their fever is more frequently accompanied by chills. Painful joints are common and often occur in conjunction with tenosynovitis and skin lesions. Polyarthralgias usually include the knees elbows and more distal joints the axial skeleton is generally spared. Skin lesions are seen in 75 of patients and include papules and pustules often with a hemorrhagic component Fig. 137-2 . Other manifestations of noninfectious dermatitis such as nodular lesions urticaria and erythema multiforme have been described. These lesions are usually on the extremities and number between 5 and 40. The differential diagnosis of the bacteremic stage of DGI includes reactive arthritis acute rheumatoid arthritis sarcoidosis erythema nodosum drug-induced arthritis and viral infections . hepatitis B and acute HIV infection . The distribution of joint symptoms in reactive arthritis differs from that in DGI Fig. 137-3 as do the skin and genital manifestations Chap. 318 . Figure 137-2 A SQUri F ud AS. Kaiptr 0L- tatunvald F. H Uf r BL Lanfli ft. Jimaion . L. LũTC l t. J H mĩữrỉ ĩ PrtĩKtpĩiĩ GỈ ỉr t fĩỉiỉ MuAchti i 17th Edit cm http jLL. snr-idi Cop rLfltit Th ComptniH. int All fight

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