A case of gonococcal necrotising fasciitis
Kudzai Nzenza Kanhutu A D , Denis D. Spelman B and Michael D. Weymouth CA Department of Infectious Diseases, The Alfred Hospital, 55 Commercial Road, Melbourne, Vic. 3004, Australia.
B Department of Microbiology, The Alfred Hospital, 55 Commercial Road, Melbourne, Vic. 3004, Australia.
C Plastic, Hand and Facio-Maxillary Surgery Unit, The Alfred Hospital, 55 Commercial Road, Melbourne, Vic. 3004, Australia.
D Corresponding author. Email: kudzaikanhutu@gmail.com
Sexual Health 11(3) 280-282 https://doi.org/10.1071/SH14027
Submitted: 4 February 2014 Accepted: 27 May 2014 Published: 24 July 2014
Abstract
This case report details the progress of a patient with severe disseminated gonococcal infection with associated necrotising fasciitis. His admission was punctuated by multiple surgical debridements and a prolonged intensive care stay due to multiple organ failure. An extended course of azithromycin-based antimicrobial therapy achieved a cure and the patient was eventually discharged home after 8 weeks. To our knowledge this is the first such case of histologically and microbiologically confirmed gonococcal necrotising fasciitis.
Additional keywords: Australia, azithromycin, gonorrhoea, Neisseria gonorrhoeae.
References
[1] World Health Organization (WHO), Department of Reproductive Health and Research. Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. Geneva: WHO; 2012. Available online at: http://www.who.int/reproductivehealth/publications/rtis/9789241503501/en/ [verified 16 June 2014].[2] Haugh PJ, Levy CS, Hoff-Sullivan E, Malawer M, Kollender Y, Hoff V. Pyomyositis as the sole manifestation of disseminated gonococcal infection: case report and review. Clin Infect Dis 1996; 22 861–3.
| Pyomyositis as the sole manifestation of disseminated gonococcal infection: case report and review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK28zgvFSltg%3D%3D&md5=74cccb9192a0477dcc317964bd6e2f67CAS | 8722952PubMed |
[3] Bowers MI, Leggat I, Barrowman JA. Disseminated gonococcal infection. Can Med J 1982; 126 1188–90.
[4] Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases, 7th edn, volume 2. Philadelphia: Churchill Livingstone Elsevier; 2010.
[5] Swarts RL, Martinez LA, Robson HG. Gonococcal pyomyositis. JAMA 1981; 246 246
| Gonococcal pyomyositis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL3M3hvVKlsg%3D%3D&md5=9a2d3df3f2318f2c87041858acd2b3adCAS | 6787219PubMed |
[6] Jitmuang A, Boonyasiri A, Keurueangkul N, Leelaporn A, Leelarasamee A. Gonococcal Subcutaneous abscess and pyomyositis: a case report. Case Rep Infect Dis 2012; 2012 790478
| 22919521PubMed |
[7] Tomlinson J. ABC of sexual health. BMJ 1998; 317 1573–6.
| ABC of sexual health.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M%2FlsFaiug%3D%3D&md5=b0b8aa894d46e12498067bef42ee57c0CAS | 9836664PubMed |
[8] Temple-Smith M, Hammond J, Pyetll P, Presswell N. Barriers to sexual history taking in general practice. Aust Fam Physician 1996; 25 S71–4.
| 1:STN:280:DyaK2s%2FgslWgtA%3D%3D&md5=2c8bd2118075d9981a7027952ecc3dc1CAS | 8854411PubMed |
[9] Kidd S, Trees D, Shapiro SJ. Cephalosporin resistant Neisseria gonorrhoeae public health response plan. Atlanta: Centers for Disease Control and Prevention; 2012. Available online at: http://www.cdc.gov/std/treatment/ceph-r-responseplanjuly30-2012.pdf [verified 16 June 2014].
[10] World Health Organization (WHO). WHO press release: urgent action needed to prevent the spread of untreatable gonorrhoea. Geneva: WHO; 2012. Available online at: http://www.who.int/mediacentre/news/notes/2012/gonorrhoea_20120606/en/ [verified 16 June 2014].
[11] Therapeutic Guidelines Ltd. Antibiotic version 14. Melbourne: Therapeutic Guidelines Ltd; 2010.
[12] Centers for Disease Control and Prevention Sexually transmitted diseases treatment guidelines, 1982. MMWR Morb Mortal Wkly Rep 1982; 31 S37–41.
[13] Centers for Disease Control and Prevention (CDC). STD treatment guidelines, 2010. Atlanta: CDC; 2010. Available online at: http://www.cdc.gov/std/treatment/2010/default.htm [verified 16 June 2014].
[14] Bignell C, Fitzgerald M. UK national guideline for the management of gonorrhoea in adults, 2011. Int J STD AIDS 2011; 22 541–7.
| UK national guideline for the management of gonorrhoea in adults, 2011.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3MbhtFWntw%3D%3D&md5=a76cab21f8b407e6f0b836f03d431976CAS | 21998172PubMed |
[15] Centers for Disease Control and Prevention (CDC) Update to CDC’s Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections. MMWR Morb Mortal Wkly Rep 2012; 61 590–4.
| 22874837PubMed |
[16] Unemo M, Golparian D, Limnios A, Whiley D, Ohnishi M, Lahra MM, et al In vitro activity of ertapenem versus ceftriaxone against Neisseria gonorrhoeae isolates with highly diverse ceftriaxone MIC values and effects of ceftriaxone resistance determinants: ertapenem for treatment of gonorrhoea? Antimicrob Agents Chemother 2012; 56 3603–9.
| In vitro activity of ertapenem versus ceftriaxone against Neisseria gonorrhoeae isolates with highly diverse ceftriaxone MIC values and effects of ceftriaxone resistance determinants: ertapenem for treatment of gonorrhoea?Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XpsV2isrg%3D&md5=8684c9d3b6e599db53951c1685b1f585CAS | 22547617PubMed |
