Overview
Introduction
A patient with a few pustules on the hands, migrating joint pain, and painful swelling along a tendon may have more than a localized skin or joint problem.
A patient with a few pustules on the hands, migrating joint pain, and painful swelling along a tendon may have more than a localized skin or joint problem. Disseminated gonococcal infection (DGI) occurs when *Neisseria gonorrhoeae* enters the bloodstream from a mucosal infection and seeds distant tissues. The pattern to recognize is dermatitis, migratory polyarthralgia, and tenosynovitis. Genital or urinary symptoms may be absent, particularly when the original mucosal infection was asymptomatic. DGI is therefore an invasive gonococcal syndrome: obtain appropriate specimens promptly, assess for organ-threatening complications, and do not use a negative low-yield culture to dismiss the diagnosis.