Gonococcal - Purulent arthritis
Canadian Guidelines on Sexually Transmitted Infections - Gonococcal Infections
- Test, and treat regardless of clinical signs/symptoms, all recent (60 days) sexual contacts.
- Recurrent gonococcal septic arthritis warrants investigation for complement deficiency.
- Diagnostic tests:
- test for HIV, syphilis, chlamydia, and hepatitis B (if no history of vaccine)
- cultures of blood and synovial fluid for Neisseria gonorrhoeae
- NAAT and culture from skin lesions for Neisseria gonorrhoeae
- NAAT and culture from urine or vaginal/endocervical specimen for Neisseria gonorrhoeae
- Anal and/or pharyngeal swabs for NAAT and culture for Neisseria gonorrhoeae in persons performing oral sex and /or having receptive anal intercourse.
Usual Pathogens
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Joint drainage | ||
| + | ||
| Ceftriaxone | 2g IV daily | 7-14 days |
| + | ||
| Azithromycin | 1g PO | 1 dose |
| Alternative | ||
| Joint drainage | ||
| + | ||
| Ceftriaxone | 2g IV daily | 7-14 days |
| + | ||
| Doxycycline | 100mg PO bid | 7 days |