emDocs - May 17, 2021 - By Yenimar Ventura; Muhammad Waseem
Reviewed by: Tim Montrief; Alex Koyfman; Brit Long
“Take-Home Messages
- The diagnosis of DGI for ED physicians is challenging as its presentation can lead directly to a wide range of diagnostic possibilities and no immediate test results are available in the ED.
- Maintain a high suspicion of DGI, particularly in young adults presenting with migratory polyarthralgia, arthritis, or tenosynovitis. A careful evaluation of the skin may identify a skin lesion which may be painless or subtle.
- DGI is a clinical diagnosis that can be confirmed by the isolation of Neisseria gonorrhoeae from blood, CSF, or synovial fluid culture and gram stain. Even though the sensitivity of cultures and gram stain is low, these are the confirmatory tests in DGI.
- Specimens should be obtained from the urethra, endocervix, vagina, or urine for NAATs. These all manifest a greater sensitivity and can support the diagnosis of DGI.”