ACUTE GONOCOCCAL ARTHRITIS - AN UNUSUAL HOST AND PATHOGEN COMBINATION

A 76 year old man was admitted for evaluation and treatment of acute o ligoarticular arthritis having recently returned from India. He was di abetic on admission. Neisseria gonorrhoeae was isolated from pus colle cted by arthrocentesis of his right knee and was subsequently found to be chromosomally resistant to penicillin. The isolate required prolin e for growth and expressed the protein 1B-1 serovar. These characteris tics of host and pathogen are atypical in that gonococcal arthritis us ually occurs in young women and is usually caused by N gonorrhoeae iso lates exhibiting hypersusceptibility to penicillin, the arginine, hypo xanthine and uracil requiring auxotype, and the protein 1A serotype. T he patient responded well to therapy with oral ciprofloxacin and initi al high dose penicillin.