Disseminated Gonococcal Infection in Japan: A Case Report and Literature Review

Abstract

Disseminated gonococcal infection (DGI) is quite a rare condition, especially in the Japanese population; only 10 cases have been reported in case notes and minutes. We describe a man in which Neisseria gonorrhoeae was suspected to have infected the patient through his pharynx. He developed chills, fever, tonsillitis, papules, tenosynovitis and migratory polyarthralgia without genitourinary symptoms. After conducting a literature review, we suggest that being male is a possible risk factor and that blood culture can be used for diagnosing DGI in Japan. DGI should be considered as a diagnosis for patients with fever, dermatitis and joint pain in Japan.

The epidemiology of gonococcal arthritis in an Indigenous Australian population

“…However, it should be noted that some countries report a higher occurrence of DGI in the male population 12. Despite the average age of this cohort (27.8 years) being slightly older than previously described (22 years13 14), here we report that adolescent girls aged 10–14 years are particularly at risk of developing DGI.…”

Innate Recognition by Neutrophil Granulocytes Differs between Neisseria gonorrhoeae Strains Causing Local or Disseminating Infections

“…Thinking in evolutionary terms, a disseminated form of the disease, probably supported by the exclusive expression of Opa CEA-e proteins, as seen for N. gonorrhoeae VP1 or as seen for the meningococcal strains analyzed, should be a dead end for these exquisitely adapted pathogens. Indeed, taking into account the large number of people colonized by meningococci or infected by gonococci, disseminated forms of disease are the exception (3,57,58). Therefore, one could speculate that a balance in the expression of Opa CEA-a and Opa CEA-e proteins might favor localized infection and reduce the chance of disseminated disease.…”

Disseminated Gonococcal Infection in An Elderly Japanese Man

“…However, Suzaki et al reviewed 11 cases of DGI in Japan and reported that the patients were primarily young to middle-aged men (a male-female ratio of 9 to 2; age range, 15 to 57 years old; average age, 39.8 years old) (8). The reason why men outnumber women in the occurrence of DGI in Japan is not conclusive in the literature; however, our patient was also male.…”