Flexor Tenosynovitis Caused by Neisseria gonorrhea Infection: Case Series, Literature Review, and Treatment Recommendations

Neisseria gonorrhoeae is the most common sexually transmitted disease in the world and is known to cause disseminated disease, most commonly tenosynovitis. Classically, gonorrhea-associated tenosynovitis presents with concomitant dermatitis and arthralgias, though this is not always the case. N. gon...

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Main Authors: Nirbhay Jain, Sean Saadat, Mytien Goldberg
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2023-03-01
Series:Archives of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/a-1938-0837
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author Nirbhay Jain
Sean Saadat
Mytien Goldberg
author_facet Nirbhay Jain
Sean Saadat
Mytien Goldberg
author_sort Nirbhay Jain
collection DOAJ
description Neisseria gonorrhoeae is the most common sexually transmitted disease in the world and is known to cause disseminated disease, most commonly tenosynovitis. Classically, gonorrhea-associated tenosynovitis presents with concomitant dermatitis and arthralgias, though this is not always the case. N. gonorrhoeae-related tenosynovitis has become more commonly seen by hand surgeons. To aid in management, we present three cases of gonorrhea-induced tenosynovitis spanning a range of presentations with variable treatments to demonstrate the variety of patients with this disease. Only one of our patients had a positive gonococcal screening test and no patient had purulent urethritis, the most common gonorrhea-related symptom. A separate patient had the classic triad of tenosynovitis, dermatitis, and arthralgias. Two patients underwent operative irrigation and debridement, and one was managed with anti-gonococcal antibiotics alone. Though gonorrhea is a rare cause of flexor tenosynovitis, it must always be on the differential for hand surgeons when they encounter this diagnosis. Taking an appropriate sexual history and performing routine screening tests can assist in the diagnosis, the prescription of appropriate antibiotics, and potentially avoiding an unnecessary operation.
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spelling doaj.art-cd75360605d74375888e048f062dc2e32023-03-28T23:45:00ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712023-03-01500221621910.1055/a-1938-0837Flexor Tenosynovitis Caused by Neisseria gonorrhea Infection: Case Series, Literature Review, and Treatment RecommendationsNirbhay Jain0Sean Saadat1Mytien Goldberg2Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, CaliforniaDivision of Plastic and Reconstructive Surgery, University of California, Los Angeles, CaliforniaDivision of Plastic and Reconstructive Surgery, University of California, Los Angeles, CaliforniaNeisseria gonorrhoeae is the most common sexually transmitted disease in the world and is known to cause disseminated disease, most commonly tenosynovitis. Classically, gonorrhea-associated tenosynovitis presents with concomitant dermatitis and arthralgias, though this is not always the case. N. gonorrhoeae-related tenosynovitis has become more commonly seen by hand surgeons. To aid in management, we present three cases of gonorrhea-induced tenosynovitis spanning a range of presentations with variable treatments to demonstrate the variety of patients with this disease. Only one of our patients had a positive gonococcal screening test and no patient had purulent urethritis, the most common gonorrhea-related symptom. A separate patient had the classic triad of tenosynovitis, dermatitis, and arthralgias. Two patients underwent operative irrigation and debridement, and one was managed with anti-gonococcal antibiotics alone. Though gonorrhea is a rare cause of flexor tenosynovitis, it must always be on the differential for hand surgeons when they encounter this diagnosis. Taking an appropriate sexual history and performing routine screening tests can assist in the diagnosis, the prescription of appropriate antibiotics, and potentially avoiding an unnecessary operation.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1938-0837flexor tenosynovitisgonorrheanonoperative management
spellingShingle Nirbhay Jain
Sean Saadat
Mytien Goldberg
Flexor Tenosynovitis Caused by Neisseria gonorrhea Infection: Case Series, Literature Review, and Treatment Recommendations
Archives of Plastic Surgery
flexor tenosynovitis
gonorrhea
nonoperative management
title Flexor Tenosynovitis Caused by Neisseria gonorrhea Infection: Case Series, Literature Review, and Treatment Recommendations
title_full Flexor Tenosynovitis Caused by Neisseria gonorrhea Infection: Case Series, Literature Review, and Treatment Recommendations
title_fullStr Flexor Tenosynovitis Caused by Neisseria gonorrhea Infection: Case Series, Literature Review, and Treatment Recommendations
title_full_unstemmed Flexor Tenosynovitis Caused by Neisseria gonorrhea Infection: Case Series, Literature Review, and Treatment Recommendations
title_short Flexor Tenosynovitis Caused by Neisseria gonorrhea Infection: Case Series, Literature Review, and Treatment Recommendations
title_sort flexor tenosynovitis caused by neisseria gonorrhea infection case series literature review and treatment recommendations
topic flexor tenosynovitis
gonorrhea
nonoperative management
url http://www.thieme-connect.de/DOI/DOI?10.1055/a-1938-0837
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