2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

Disseminated Gonococcal Infection (DGI)

0.5-3%ofgonococcal infections

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Risk factors: female/menses/pregnancy, terminal complement deficiency Clinical presentation • Mono-articular septic arthritis • Skin lesions (petechial or pustular) + tenosynovitis + polyarthralgia • Perihepatitis, endocarditis, meningitis Mucosal site-asymptomatic (NAAT) Antimicrobial susceptibility (AST)culture DGI Infection associated with eculizumab • FDAadverse event reporting system (Crew 2018)

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Changing Patterns of DGI

DGI Cases Surveillance, 2015 – 2018

• GC Sterile site isolate (CA, GA) • 2015-16 (retrospective); 2017-prospective • 52 cases • Demographics- 59% male (MSM 16%), 15- 29 yo (34%) , >45yr (34%) • 25% septic arthritis • 13% HIV+ • Underestimate of true burden of DGI • Surveillance area ~4% of US population

Weston, Emerging IDConference 2018

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Belkacem,SexTrans Infect2013

Neisseria gonorrhoeae — GISP,2000–2018

CDC,2018 Surveillance

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