Infect Chemother.  2004 Jun;36(3):175-180.

A Case of Concomitant Disseminated Gonococcal Infection with Acute Viral Hepatitis C

• Kim GC
• Lee CH
• Lee JS
• Chung MH
• Choi JH
• Moon YS

Abstract

Gonorrhea is endemic in developing countries. Frequent sexual contacts are common among travellers to endemic countries and the risk of sexually transmitted disease as gonorrhea is believed to be high. Disseminated gonococcal infection (DGI) results from blood dissemination of Neisseria gonorrhoeae from the primary mucosal infection and is a common cause of infective arthritis in sexually active adults in the USA. The usual manifestations of DGI are dermatitis, tenosynovitis, and septic arthritis. We experienced a case of DGI concomitant with acute viral hepatitis C, probably acquired by sexual contacts in Philippines. A 40-year-old man took a trip to Philippines and stayed for a week. During his stay in Philippines, a hemorrhagic bulla and several pustules developed on his extrimities. Subsequently he suffered from high fever and arthralgia of several joints, including both knee joints. Neisseria gonorrhoeae was identified by culture of an aspirate from the right knee joint and he was managed with ceftriaxone for 3 weeks under the diagnosis of DGI and gonococcal arthritis. During the follow-up at the outpatient clinic, alanine aminotransferase and aspartate aminotransferase levels began to rise and an anti-HCV antibody became positive. Because HCV viral loads were surging up from 56,703 copies/mL to 538,292 copies/mL during the next 4 weeks, interferon-alpha 2b was administered for 6 months with resultant normal liver function tests and undetectable HCV viral loads.

Keyword

Sexually transmitted diseases; Disseminated gonococcal infection; Hepatitis C virus; International Travel

MeSH Terms

Adult
Alanine Transaminase
Ambulatory Care Facilities
Arthralgia
Arthritis
Arthritis, Infectious
Aspartate Aminotransferases
Ceftriaxone
Dermatitis
Developing Countries
Diagnosis
Fever
Follow-Up Studies
Gonorrhea
Hepacivirus
Hepatitis C*
Hepatitis*
Humans
Interferon-alpha
Joints
Knee Joint
Liver Function Tests
Neisseria gonorrhoeae
Philippines
Sexually Transmitted Diseases
Tenosynovitis
Viral Load
Alanine Transaminase
Aspartate Aminotransferases
Ceftriaxone
Interferon-alpha