Thread by @guerreroespejo

A 26-yo👩‍🦰, #sexually active, with 1 partner: right knee and metacarpal arthralgia, tenosynovitis and pustules on her hand.

CT: an abscess on her chest wall
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doi.org/10.1503/cmaj.2…
#IDtwitter #MedTwitter #emergency

✔️Urine gonococcal nucleic acid amplification test (NAAT):➕
✔️🧫from the patient’s chest wall fluid:➖but
✔️16S rRNA with gene sequencing confirmed presence of Neisseria gonorrhoeae.

CHEST WALL ABSCEST WITH DISSEMINATED GONOCOCAL INFECTION
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#microbiology #MolBiol

Her doctors treated her with incision and drainage and intravenous ceftriaxone 2 g/d. for 17 days after resolution of the abscess

If chlamydia infection has not been ruled out, chlamydia treatment with doxycycline for 7 days should be added.
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#surgery #MedStudentTwitter

Neisseria gonorrhoeae is a highly infectious Gram-negative diplococcus transmitted mainly through unprotected vaginal, anal and oral intercourse.
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#MedicalStudents #sexual

NAAT is now the recommended method for diagnosis of N. gonorrhoeae as
✔️it provides increased sensitivity while maintaining high specificity,
✔️compared with 🧫 for detecting N. gonorrhoeae in samples from genital and nongenital sites.
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#microbiology #MolBiol #bacteriology

Nucleic acid amplification tests are designed to amplify and detect organism-specific nucleic acid sequences and do not require viable organisms to be present in samples.
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#MedStudentTwitter #MedicalStudents

16S rRNA is a highly conserved gonococcal nucleic acid that, when targeted in testing, allows for identification of bacteria to the species level.
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#sexually #resident

Nucleic acid amplification testing should be done using ✔️first-void urine samples or
✔️swabs from the vagina, cervix, urethra, rectum or other site of clinical concern.
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#sexual #MedEd #Doctor

Given the rates of N. gonorrhea infections, clinicians should maintain a high degree of suspicion in sexually active patients.
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#IDtwitter #MedTwitter #medicine