Gonococcal Arthritis in an Adolescent Girl

Gonococcal arthritis may occur in female adolescents, may involve more than one joint, and the Neisseria gonorrhoeae organism may be recovered from the periarticular tissues after initial acute inflammation has subsided, as illustrated by a girl aged 14 years and 8 months. Intravenously given penicillin G sodium, 100,000 units/kg in four equal doses for four days and orally given penicillin for an additional two weeks was administered. She showed dramatic clinical improvement within 24 hours of definitive treatment. Roentgenograms of joints showed no bone involvement. Although the incidence of gonococcal arthritis in patients with gonorrhea is only about 1%, prompt diagnosis and treatment of this and other types of septic arthritis in a child is important because subsequent growth tends to exaggerate joint residua. Penicillin, which is effectively transported into the synovial fluid, is the antibiotic of choice.