Disseminated Gonococcal Infection: An emerging challenge. A case report

Globally, gonorrhoea is the second commonest bacterial sexually transmitted infection. In 2023, reported gonorrhoeae cases in Sri Lanka have increased accounting for 10% from total reported STDs. Delayed diagnosis or inadequate treatment may cause systemic complications like disseminated gonococcal infections (DGI). Though known DGI prevalence is <1%, per estimations it is 0.5% - 3% among untreated cases. We report a 28-year-old unmarried male, initially treated for smear positive, culture negative urethral gonorrhoea with oral cefixime and azithromycin, presented one week after treatment with atypical skin lesions. This case highlights diagnostic and therapeutic challenges in the current context of rising gonococcal incidence and emerging antibiotic resistance. Atypical presentation can delay the diagnosis and treatment. Improved awareness among clinicians, improving advanced diagnostic facilities availability, effective partner notification and national surveillance are the key to prevent emerging threat of DGI.