skip to main content

Disseminated Gonococcal Infection — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateSTIsDisseminated Gonococcal InfectionSCE Infectious Diseases

A 40-year-old woman presents with acute monoarthritis of the right wrist. She is an IV drug user. Synovial fluid shows 55,000 WCC/µL (90% neutrophils), negative Gram stain, and no crystals. Blood cultures grow Neisseria gonorrhoeae. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Disseminated gonococcal infection (DGI) with septic arthritis

Disseminated gonococcal infection (DGI) causes a triad of migratory polyarthralgia, tenosynovitis, and dermatitis, which can evolve into frank septic arthritis (typically monoarticular — wrist, knee, ankle). N. gonorrhoeae bacteraemia confirms DGI. Joint fluid Gram stain is often negative in gonococcal arthritis (unlike staphylococcal). Treatment is IV Ceftriaxone 1 g daily (or 2 g for meningitis/endocarditis) for at least 7 days, switching to oral guided by sensitivities. Full STI screen and partner notification are essential.

Reference: BASHH 2019 – Gonorrhoea; BSR 2023 – Septic arthritis guidelines