[Gonorrheal arthritis].

A 43-year-old female patient presented with migratory arthralgias, generalized exanthema and arthritis of the left elbow. She had a history of fever and chills three days earlier. Beside to a maculopapular and pustular rash and a joint involvement we found a swelling of the dorsal surface of her right hand without wrist effusion or synovitis. The clinical presentation was typical for the diagnosis of disseminated gonococcal infection (arthritis-dermatitis syndrome). Arthrocentesis was performed, and the cultures of the synovial fluid on chocolate agar were positive for Neisseria gonorrhoeae. The serologic examination for gonococcus was negative, it became positive some weeks later. The therapy with intravenous penicillin G 6 x 10(6) units/day for ten days was successful; unfortunately, we could not treat the partner. The present case report is illustrated with colour prints and describes the typical clinical picture of a diagnosis which is nowadays rare or even forgotten.