FEBRILE DERMATOSIS – A DIAGNOSIS NOT TO FORGET

  • Pedro Mendes-Bastos Interno de Dermatovenereologia, Serviço de Dermatologia e Venereologia, Hospital de Curry Cabral, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
  • Vasco Coelho-Macias Assistente Hospitalar de Dermatovenereologia, Serviço de Dermatologia e Venereologia, Hospital de Curry Cabral, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
  • Cândida Fernandes Assistente Hospitalar Graduada de Dermatovenereologia, Serviço de Dermatologia e Venereologia, Hospital de Curry Cabral, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
  • Jorge Cardoso Diretor de Serviço, Serviço de Dermatologia e Venereologia, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
Keywords: Gonorrhea, skin diseases, Sexually transmitted diseases, Bacterial

Abstract

A 46 year-old male patient with HIV-1/HCV coinfection and liver cirrhosis admitted with fever, prostration, and asthenia. On physical examination, scarce necrotic pustules on an erythematous base on the fingers and toes with swelling, pain and functional limitation of the left tibiotarsal joint were noted. Laboratory revealed only slight elevation of liver enzymology and CRP. We admitted the diagnostic hypotheses of endocarditis, meningococcemia or gonococcemia. After isolation of Neisseria gonorrhoeae from a blood culture, intravenous ceftriaxone was started with clinical improvement. Pharyngeal swab PCR positivity for N. gonorrhoeae confirmed the diagnosis of pharyngeal origin disseminated gonococcemia. Gonorrhea is a sexually transmitted infection caused by Gram-negative diplococcus Neisseria gonorrhoeae. Disseminated gonococcemia in the form of the classical "arthritis-dermatitis" syndrome accompanies only 1-2% of mucosal infections. Pharyngeal gonorrhea is often asymptomatic in men and women, probably constituting an important reservoir of the agent. The rise in gonorrhea incidence makes this case very pertinent in any dermatologist’s clinical practice today.

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How to Cite
Mendes-Bastos, P., Coelho-Macias, V., Fernandes, C., & Cardoso, J. (1). FEBRILE DERMATOSIS – A DIAGNOSIS NOT TO FORGET. Journal of the Portuguese Society of Dermatology and Venereology, 73(1), 141-145. https://doi.org/10.29021/spdv.73.1.356
Section
Case Reports