A case of purulent gonococcal arthritis

We present a case of a generally healthy, immunocompetent, 57 year old male on HIV pre-exposure prophylaxis (PrEP) who developed the sudden onset of right wrist pain and swelling with associated left second finger tenosynovitis, due to a disseminated gonococcal infection (DGI) with purulent arthritis. This case’s aim is to demonstrate a well-documented but infrequently seen manifestation of Neisseria gonorrhoeae infection and to highlight the need for awareness of extragenital manifestations of gonococcal infection in the era of HIV PrEP. DGI accounts for less than 3 % of N. gonorrhoeae infections, with purulent arthritis being one presentation. The incidence of N. gonorrhoeae infections has increased in recent years and is high among those taking PrEP. Providers should be aware of the possibility of DGI and N. gonorrhoeae as a potential etiologic agent in septic bacterial arthritis.