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We describe the first reported case of gonococcal septic shock with associated acute respiratory distress syndrome and multisystem organ failure, in which the patient made a full recovery, and add to the paucity of descriptive literature on gonococcal sepsis. The case was a 36-year-old previously healthy Aboriginal female from northern Canada. Trea...
Context in source publication
Context 1
... Journal of Infectious Diseases On the second day of admission, the peripheral microbiology laboratory reported Gram-negative diplococci from initial blood cultures. The evolving physical examination demonstrated previ- ously undocumented conjunctival suffusion, bilateral knee effu- sions, and multiple purpuric lesions on the palms, fingers, shins, and soles of the feet (Figure 1). A pustular lesion was noted on the right lateral thigh (Figure 2). ...
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Citations
... Another study reported that, for psychiatric patients, hospitalisation rates are higher if the primary source of health care is an hospital rather than a nursing centre [32]. Finally, one study was a case report and no conclusions can therefore be drawn [33]. ...
... Rose's study found that Indigenous patients underwent more forefoot and below the knee amputations and fewer toe or above the knee amputations for diabetes-related complications [90]. Finally, seven articles did not provide any comparison with non-Indigenous patients [33,[109][110][111][112]124]. ...
... One article found no difference between the length of stay in the emergency department for Indigenous and non-Indigenous patients [103]. Six studies did not provide any comparison with non-Indigenous patients [33,36,37,52,108,112]. There was no difference in length of stay for Indigenous patients with traumatic brain injury [122], blastomycosis of bones [28] or appendicitis [123]. ...
A recent report by the Chief Public Health Officer of Canada demonstrates the inferior health status of Indigenous Peoples in Canada when compared to non-Indigenous populations. This scoping review maps out the available literature concerning acute health care for Indigenous Peoples in Canada in order to better understand the health care issues they face. All existing articles concerning health care provided to Indigenous Peoples in Canada in acute settings were included in this review. The targeted studied outcomes were access to care, health care satisfaction, hospital visit rates, mortality, quality of care, length of stay and cost per hospitalisation. 114 articles were identified. The most studied outcomes were hospitalisation rates (58.8%), length of stay (28.0%), mortality (25.4%) and quality of care (24.6%) Frequently studied topics included pulmonary disease, injuries, cardiovascular disease and mental illness. Indigenous Peoples presented lower levels of satisfaction and access to care although they tend to be over-represented in hospitalisation rates for acute care. Greater inclusion of Indigenous Peoples in the health care system and in the training of health care providers is necessary to ensure a better quality of care that is culturally safe for Indigenous Peoples.
... In rare circumstances, gonococcal infection may result in sepsis and septic shock [4]. Gonococcal sepsis is most common in young women, but may develop in sexually active persons of any age. ...
Background:
Neisseria gonorrhoeae is a Gram-negative bacterium which affects the urethra, throat, rectum and cervix of patients and often associated with sexually transmitted infections. The global epidemiology of the disease is not well characterised especially in resource constraint countries due to poor diagnostic capacity and inefficient reporting systems. Although important, little is known about the propensity of this bacterium to cause sepsis in immunocompetent individuals.
Case presentation:
A 32-year-old female presented with fever and generalised malaise to a rural hospital in Ghana. The patient had previously been diagnosed as having enteric fever from a neighbouring health facility. Blood and urine samples were collected from the patient and cultured using standard microbiological and molecular techniques. Neisseria gonorrhoeae was isolated from the blood which was resistant to penicillin, ciprofloxacin and cotrimoxazole. The patient recovered following ceftriaxone and azithromycin treatment.
Conclusion:
This case highlights the importance of N. gonorrhoeae in causing sepsis and emphasises the need for blood culture investigation in diagnosis of patients presenting with fever.
... Importantly, untreated or incompletely treated N. gonorrhoeae infection can lead to significant and potentially life-threatening sequelae including pelvic inflammatory disease, epididymitis and infertility [4]. Disseminated gonococcal infection can lead to septic arthritis and in rare cases septic shock and death [5]. Accurate data regarding the prevalence of sexually transmitted infections in the Georgian military population is currently lacking. ...
Antimicrobial resistance in Neisseria gonorrhoeae (N. gonorrhoeae) is a global health problem. Enhanced international collaborative surveillance and disease control is needed to reduce the global burden of this important pathogen. Currently, the antimicrobial resistance properties and molecular mechanisms of multidrug resistant N. gonorrhoeae in the country of Georgia represent a significant knowledge gap. Here we report the isolation of a strain of N. gonorrhoeae exhibiting resistance to cefixime and ciprofloxacin with reduced susceptibility to penicillin and tetracycline from a patient being treated at a Georgian medical center. Notably, this isolate was found to contain a mosaic penA allele; and to harbor mutations in genes conferring susceptibility to the beta-lactam, cephalosporin, fluoroquinolone, macrolide and penicillin classes of antibiotic. To our knowledge, this is the first report to describe the key mutations conferring the antimicrobial resistance properties of an isolate of N. gonorrhoeae from the country of Georgia.
Neisseria gonorrhoeae is one of the microbes that can causes male urethritis. This microbe is most likely to be transmitted via sexual intercourse. In men, the representative infection sites are the urethra, and oral mucosa but gonococcemia is rere. We present a case of gonococcemia in a 47‐year‐old male successful kidney recipient. He temporarily lost his graft function due to acute kidney injury followed by sepsis; however, short‐course intermittent hemodialysis and long‐term intensive ceftriaxone inoculation saved his life and his graft function.
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