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Disseminated gonorrhea presenting as cellulitis of the hand: A case report

Year: 2025

Type: article

Abstract: A 35-year-old man presented with left-hand pain, swelling, and erythema. He was initially treated with prednisone, and his symptoms briefly improved but worsened shortly after. Lab tests showed elevated inflammatory markers, and he was referred to rheumatology for suspected rheumatoid arthritis. He later returned to the emergency department with worsening joint pain and painful urination. Imaging revealed muscle swelling without abscess, and he was treated with intravenous antibiotics for presumed cellulitis. Although symptoms improved, cultures later confirmed gonorrhea. He received ceftriaxone and azithromycin at urgent care; then completed intravenous treatment at the hospital. This case illustrates an unusual presentation of disseminated gonorrhea, which typically affects skin and joints, but can mimic cellulitis. Clinicians should consider gonorrhea in the differential diagnosis of unexplained joint pain and swelling, especially when accompanied by urinary symptoms or skin involvement, even in the absence of typical signs of a sexually transmitted infection.

Source: SAGE Open Medical Case Reports

DOI: 10.1177/2050313x251395983

Authors: Alekhya Gurram, Noah Karnath, Rahul S Nanduri, Khushali Roy, Bernard Karnath

Institution: The University of Texas Medical Branch at Galveston

Language: English

Topic: Reproductive tract infections research

Subfield: Microbiology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,000