Case report: Disseminated gonococcal infection, a story of camouflage and deceit

Abstract

We report on a 38-year-old male patient with disseminated gonococcal infection. Preceding the discharge diagnosis, the patient was treated regarding rheumatoid arthritis, which resulted in the deterioration of the patient's medical condition due to the immunomodulatory nature of the applied medication. The causative agent was identified by culturing joint puncture fluid inoculated into blood culture vials. Primary infection with the pathogen could not be pinpointed in terms of time, but on further questioning, the patient reported intimate contacts with a number of different male partners, which may be assumed to have included the infection source. The case hereby demonstrates the impact that an early misdiagnosis and a limited anamnesis can have on the progress of a patient's disease. Furthermore, this case has helped us to propose possible improvements in both clinical and microbiological diagnostic approaches.