• Young (< 40 years old)
• Women (because they are usually asymptomatic)
• 0.5-3% of people infected with N. gonorrheae
• Common cause of acute arthritis in young people

Clinical Manifestations

• 1) triad of tenosynovitis (migratory), dermatitis (painless lesions – usually pustular or vesiculopustular), and polyarthralgias (small or large joints – usually asymmetric)
• 2) purulent arthritis without skin lesions – usually one joint affecting knees, wrist, or ankles

Evaluation

• Clinical suspicion – thorough history of physical
• Blood cultures
• Specimen from mucosal sites – urogenital, rectal, pharyngeal
• Synovial fluid – only positive 50% of the time – NAAT testing better than cultures

Treatment

• Ceftriaxone 7-14 days (can give IM if non-purulent arthritis)
• Remember to co-treat for chlamydia with azithromycin