First Case Report of Disseminated Gonococcal Arthritis in Newfoundland & Labrador

Introduction: Disseminated gonococcal infections (DGIs) are a rare but often debilitating complication of N. gonorrhoeae infections. Often presenting as arthritis-dermatitis syndrome, true suppurative joint infections are an even more rare form of DGI. Here, we present the first known case of DGI in Newfoundland and Labrador in over 10 years. Case report: A 50-year-old man who is known to inject drugs with multiple housing and social challenges presented to the emergency department with a two-day history of an isolated painful, erythematous knee. After being assessed by orthopedics and undergoing an operative debridement, intraoperative cultures grew N. gonorrhoeae. He was treated with IV ceftriaxone, and his course in hospital was complicated by inadequate pain control and a lack of stable housing.   Conclusion: DGIs, while rare, need to remain on any clinician’s differential for septic arthritis given the increasing prevalence of gonorrheal infections in Canada, and in Newfoundland and Labrador. In addition, patients who are at risk of delaying accessing care, such as people who inject drugs and unhoused individuals, are at higher risk of complicated hospital stays.