Right hip gonococcal septic arthritis treatment with successful transition to oral fluoroquinolone

BMJ Case Rep. 2022 Sep 16;15(9):e251050. doi: 10.1136/bcr-2022-251050.

Abstract

We present a case of gonococcal septic arthritis of the right hip diagnosed via synovial fluid cultures. Antimicrobial susceptibility testing of the synovial fluid demonstrated susceptibility to tetracycline, ciprofloxacin, cefixime and ceftriaxone. Our patient was initially treated with ceftriaxone and was successfully de-escalated to oral levofloxacin to complete the treatment. This case is interesting given the rarity of disseminated gonococcal infections in the 21st century and that most clinical isolates of Neisseria gonorrhoeae are increasingly resistant to fluoroquinolones.

Keywords: Global Health; Gonorrhoea; Infectious diseases; Medical management; Sexual transmitted infections (bacterial).

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Arthritis, Infectious* / drug therapy
  • Cefixime / therapeutic use
  • Ceftriaxone / therapeutic use
  • Ciprofloxacin / therapeutic use
  • Drug Resistance, Bacterial
  • Fluoroquinolones / therapeutic use
  • Gonorrhea* / complications
  • Gonorrhea* / diagnosis
  • Gonorrhea* / drug therapy
  • Humans
  • Levofloxacin / therapeutic use
  • Tetracycline / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones
  • Ciprofloxacin
  • Levofloxacin
  • Ceftriaxone
  • Cefixime
  • Tetracycline