[Gonococcal arthritis: neither so common nor so straightforward. Clinical description of cases diagnosed in northern Spain between 2013 and 2023].

Authors

Laura Guio Carrión, María José Blanco Vidal, Leire Toscano Ruiz, Juan Carlos Gainzarain Arana, Marta Fernández-Sampedro, Miguel Ángel Goenaga Sánchez, Víctor Polo Sanricardo, Begoña Vilar Achabal, Marina Fernández Torres, Daniel Pablo Marcos, Malen Aguirregabiria Padilla, José Luis Díaz de Tuesta Del Arco

Published in

Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia. Aug 10, 2026. Epub Aug 10, 2026.

Abstract

Given the current increase in the incidence of Neisseria gonorrhoeae infection, a rise in disseminated forms of the disease may also be expected. Within disseminated gonococcal disease, gonococcal arthritis has specific clinical, diagnostic and therapeutic characteristics.
A retrospective search was conducted for synovial fluid samples that tested positive for N. gonorrhoeae by culture or molecular biology techniques between 2013 and 2023 at several hospitals in northern Spain. A descriptive analysis was subsequently performed.
Fifteen patients were analysed. Monoarthritis was the most frequent presentation (60%), followed by polyarthritis, predominantly affecting the wrist or knee. Arthralgia or tenosynovitis at other sites, particularly the wrist, was common. Microbiological identification was performed by conventional culture (12/14) or PCR (7/7). Repeated ultrasound-guided drainage or surgical washout was required in 30% of cases. The mean duration of intravenous antibiotic therapy was 12 days, while the mean total duration of antibiotic therapy was 22 days. The clinical response was favourable in all cases.
In the current context of increasing gonococcal infection incidence, gonococcal arthritis should be considered in patients with septic monoarthritis or polyarthritis and concomitant tenosynovitis, particularly when the radiocarpal joint is involved. Molecular biology techniques may be useful for identifying N. gonorrhoeae in suspected cases. The clinical course may vary and may require surgical washout and prolonged treatment.

PMID:
42576629
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.

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