Case Report of Urethritis in a Male Patient Infected with Two Different Isolates of Multiple Drug-Resistant Neisseria gonorrhoeae

Abstract

We report a brief description of a case suffering from bacterial urethritis, conjunctivitis, and arthritis, caused by two different isolates of multiple drug-resistant Neisseria gonorrhoeae. Initial diagnosis was dependent on the patient history, clinical findings, symptoms, and the bacteriological data. Polymerase chain reaction confirmed the identification of the pathogens. Random amplified polymorphic DNA revealed two different patterns. Susceptibility testing was performed using Kirby–Bauer disk diffusion method and the minimum inhibitory concentration was also determined. It revealed multiple drug resistance associated with β-lactamase production. Only gentamicin, rifampicin, and azithromycin were active against the test pathogens. A dual therapy was initiated using gentamicin as well as azithromycin to treat the possible co-infection with Chlamydia trachomatis. Complete recovery of the patient achieved with resolved symptoms a week later.

HIV-Negative MSM Infected with Two Different Isolates of Drug-Resistant Neisseria gonorrhoeae—Case Report

“…To date, only a few similar reports have been described in the literature. Al-Madboly L. et al, described a case report of urethritis, conjunctivitis, and arthritis in a male patient infected with two different isolates of multiple drug-resistant Neisseria gonorrhoeae [ 14 ]. It revealed multiple drug resistances associated with β-lactamase production; only gentamicin, rifampicin, and azithromycin were active against the described pathogens.…”

“…It revealed multiple drug resistances associated with β-lactamase production; only gentamicin, rifampicin, and azithromycin were active against the described pathogens. A dual therapy was initiated using gentamicin as well as azithromycin to treat the patient, and the symptoms resolved a week later [ 14 ]. We previously reported the case of a bisexual MSM infected with two new strains of drug-resistant N. gonorrhoeae —the rectal isolate was resistant to penicillin, ciprofloxacin, and tetracycline while the urethral isolate was resistant to ciprofloxacin [ 15 ].…”