1. [Purulent peritonitis due to gonococcal infection].
- Author
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Geerds MAJ, van Driel LJ, Trienekens TAM, Sassen S, and Aarts F
- Subjects
- Anti-Bacterial Agents administration & dosage, Diagnosis, Differential, Female, Gonorrhea diagnosis, Gonorrhea physiopathology, Gonorrhea therapy, Humans, Middle Aged, Treatment Outcome, Ceftriaxone administration & dosage, Ileitis drug therapy, Ileitis microbiology, Ileitis physiopathology, Neisseria gonorrhoeae isolation & purification, Peritonitis drug therapy, Peritonitis microbiology, Peritonitis physiopathology
- Abstract
BACKGROUND A Neisseria gonorrhoea infection is one of the most common sexually transmitted diseases and can present both urogenitally and extragenitally. CASE DESCRIPTION A 55-year-old woman presented at the emergency room with general malaise, abdominal pain and fever. Despite extensive surgical, gynaecological and radiological investigations no clear cause could initially be found. She was subsequently admitted to the surgical unit for observation. During the admission period the patient developed diffuse peritonitis and her infection parameters were rising. Diagnostic laparoscopy revealed extensive terminal ileitis with a reactive infiltrate of the uterine fundus and purulent peritonitis. A PCR test of the abdominal exudate was strongly positive for Neisseria gonorrhoeae, but cultures remained negative. Following an 8-day course of antibiotic treatment with intravenous ceftriaxone, the patient recovered from her symptoms. CONCLUSION Terminal ileitis with peritonitis is an unusual extragenital manifestation of a gonococcal infection. In order to make a diagnosis, surgical exploration with cultures is sometimes indicated.
- Published
- 2019