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Disseminated gonococcal infection — SCE Acute Medicine MCQ

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HardSepsis and Infectious EmergenciesDisseminated gonococcal infectionSCE Acute Medicine

A 45-year-old woman presents with fever, systemic upset and acute deterioration. Relevant history includes a plausible infectious exposure or immunocompromising context. On assessment, NEWS2 is elevated and there are features of organ dysfunction. Investigations show migratory polyarthralgia, tenosynovitis and pustular rash. What is the most likely diagnosis?

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

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Correct answer: A — Disseminated gonococcal infection

The key discriminator is that migratory polyarthralgia, tenosynovitis and pustular rash, which makes Disseminated gonococcal infection the single best answer. Toxic drug ingestion is less appropriate because it does not address the dominant acute risk in the vignette; Vasculitic pulmonary-renal syndrome would fit a different presentation or later stage of care. Diabetic ketoacidosis and Acute kidney injury are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: https://www.nice.org.uk/guidance#acute-medicine-order-35-1