We report a rare case of disseminated gonococcal infection in a 37-year-old man presenting with multifocal cellulitis. The patient presented with fever and painful swelling of the right foot and left hand, and was admitted to our hospital. CT scanning of the extremities revealed multifocal cellulitis. Transthoracic echocardiography findings were normal, and piperacilin/tazoactam therapy was initiated. On antibiotic day 4, Neisseria gonorrhoeae was cultured from a purulent effusion collected from a focal site. Chlamydia trachomatis was detected in urine samples by PCR. We made the diagnosis of multifocal cellulitis due to N. gonorrhoeae in a patient with chlamydia urethritis. The antibiotic agent was changed from piperacilin/tazobactam to ceftriaxone. Levofloxacin was also administered for chlamydia urethritis. By admission day 14, all lesions had resolved and administration of antibiotic agents was terminated. Disseminated gonococcal infection, although rare, should be included in the differential diagnosis of all sexually active patients who present with multifocal cellulitis - also a rare condition, particularly in light of the fact that in recent times, patterns of sexual activity have changed, which was a pertinent factor in this case.

Case report: We report a case involving primary uterine serosal pregnancy treated via laparoscopic surgery. A 35-year-old woman with suspected ectopic pregnancy was referred to our hospital. We were unable to detect a gestational sac in the uterus or implantation site by imaging. Her urine human chorionic gonadotropin (hCG) level was 18,835 mIU/mL. Exploratory laparoscopy was performed to examine her abdominal cavity. Both of her fallopian tubes were normal. We found a gestational sac on the uterine serosal surface. Vasopressin was injected into the myometrium to reduce bleeding, and the part was dissected with minimal bleeding using monopolar and bipolar forceps. A pathological examination revealed the presence of chorionic villi and trophoblastic cells. Her postoperative course was good, and the patient was discharged on the fourth postoperative day. Overall, laparoscopic surgery was useful for the early diagnosis and treatment of peritoneal pregnancy.