Which of the following statements are true regarding the following patients diagnosis?
A healthy 27 year old female presents with atraumatic joint pain and swelling.Â Over the past 4 days, she complains of left knee, right wrist and right ankle pain.Â She denies rash or fever.Â
A. She may be discharged home on oral antibiotics after a dose of IV antibiotics B. It is unnecessary to perform a cervical culture on this patient C. This type of arthritis is more commonly oligoarthritis than monoarthritis D. The etiology of this arthritis has a high liklihood of creating long-term joint pathology E. This type of arthritis is most common in children and adults > 55 years old
This type of arthritis is more commonly oligoarthritis than monoarthritis-although it has declined over the past decade, gonococcal arthritis remains the most common form of septic arthritis in the sexually active population, with a 4:1 female predominance. gonococcal arthritis is clinically and pathologically distinct from other bacterial infections and is less likely to create long-term joint pathology. this infection is more commonly oligoarthritis than monoarthritis, with the knee, ankle and wrist being the most commonly affected joints. diagnosis is difficult as both synovial and blood cultures are positive in only 10-50% of cases. however, synovial fluid often yields a positive grams stain. cervical, urethral, rectal and pharyngeal cultures are positive in up to 75% of cases and therefore should be cultured appropriately. treatment should be with a parenteral 3rd generation cephalosporin, with transition to oral antibiotics 24-48 hours after clinical improvement. (chapter 114)