Cutaneous Manifestations of Gonococcemia

Cutaneous Vasculitis Update: Small Vessel Neutrophilic Vasculitis Syndromes

“…[79][80][81] Clinically, the extremities and sites of pressure develop hemorrhagic lesions (petechiae mostly), pustular purpura, and vesiculopustular lesions (vesicles, bullae, and erythematous macules and nodules surmounted by small pustules). [80][81][82][83][84][85][86] Histologically, septic vasculitis differs from conventional small-vessel neutrophilic vasculitis by the finding of occlusive luminal thrombi composed of platelets, red blood cells, fibrin, and neutrophils. Relative to CLA, there is less nuclear debris (leukocytoclasia), deep dermal and arteriolar involvement, marked hemorrhage, and the common presence of subepidermal and intraepidermal pustules with epidermal necrosis.…”

Gonococcaemia with arthritis, dermatitis and myocarditis

“…It is once again recognized as a common disorder, perhaps in association with the rising incidence of gonorrhoea throughout the world in the last decade (Guthe, 1972). It now occurs predominantly in females (Abu-Nassar et al, 1963;Keiser, Ruben and Wolinsky, 1968) and frequently in association with skin lesions as part of a gonococcaemia (Keil, 1938;Abu-Nassar et al, 1963;Barr and Danielsson, 1971). Distinction has been made between benign gonococcaemia and a serious illness with endocarditis (Abu-Nassar et al, 1963) However, all gradations can occur, and the severe illness with cardiac involvement should not be regarded as an illness of the pre-antibiotic area alone.…”

“…After the introduction of penicillin both syndromes were regarded as rarities until recent years (British Medical Journal, Editorial 1970). Abu-Nassar et al (1963) drew attention to the specificity of the cutaneous lesion, and the arthritisdermatitis syndrome (Holmes, Wiesner and Pederson, 1971), or benign gonococcaemia (Wolff, Goodman and Vahrman, 1970), has been increasingly recognized. It is described as a uniformly mild condition responding rapidly to penicillin (Abu-Nassar et al, 1963; Barr and Danielson, 1971).…”

“…Abu-Nassar et al (1963) drew attention to the specificity of the cutaneous lesion, and the arthritisdermatitis syndrome (Holmes, Wiesner and Pederson, 1971), or benign gonococcaemia (Wolff, Goodman and Vahrman, 1970), has been increasingly recognized. It is described as a uniformly mild condition responding rapidly to penicillin (Abu-Nassar et al, 1963; Barr and Danielson, 1971). This report describes six patients in Jamaica with gonococcaemia of varying severity-two were seriously ill, including one with myocarditis.…”

Gonococcal ulceration of the tongue in the gonococcal dermatitis syndrome.

“…Gonococci are either not demonstrable or detectable for only brief periods. Cases of this syndrome have been published by Bruusgaard and Thj0tta (1925), Keil (1938), Margolin (1943), Kvorning (1963), Abu-Nassar, Hill, Fred, and Yow (1963), Ackerman, Miller, and Shapiro (1965), Bjomberg andGisslen (1965), Fred, Eiband, Martincheck, andYow (1965), and Danielsson and Michaelsson (1966).…”