Gonococcal arthritis refers to inflammation in a joint as a result of a gonorrhea infection. Symptoms may occur when the bacteria spread through the blood and into the affected joints. It is one of many complications that occur due to untreated gonorrhea. However, treatment with antibiotics can quickly clear the infection.

Gonorrhea is a common sexually transmitted infection (STI) that can spread during any kind of sexual contact.

Treatment with antibiotics is usually effective. However, if a person does not receive treatment, gonorrhea can result in long-term complications, such as gonococcal arthritis.

This article will discuss gonococcal arthritis, including its causes, symptoms, and treatments.

A doctor checking a person for gonococcal arthritis.Share on Pinterest
Photo editing by Stephen Kelly; Mladen Zivkovic/Getty Images

Gonococcal arthritis is a form of septic arthritis. This refers to when a pathogen enters a joint and triggers inflammation, resulting in arthritis. In this case, it is an infection with the bacteria Neisseria gonorrhoeae, which are those that cause gonorrhea.

Gonorrhea is usually an STI. However, it can also occur in a newborn child if the birthing parent has gonorrhea while giving birth to them.

Gonococcal arthritis occurs from a gonorrhea infection.

Gonorrhea infections are relatively common, with the Centers for Disease Control and Prevention (CDC) noting that it is the second most commonly reported communicable disease. The CDC also estimates that up to 1.6 million new infections occur in the United States each year.

In many cases, a gonococcal infection may not cause any symptoms. This may be partly responsible for the spread of the infection.

Without treatment, gonococcal infections can cause serious and permanent health problems. In some cases, gonorrhea can spread beyond the initial infection site and enter the bloodstream. This can lead to a disseminated gonococcal infection (DGI), which causes inflammation of the skin, tendons, and joints.

DGIs occur in roughly 0.5% to 3% of people with gonorrhea infections. Although they may occur at any age, evidence suggests that they are more common in young, healthy individuals.

In some cases, people may not know that they have gonorrhea at all, as it can be asymptomatic.

However, symptoms can include a burning sensation while urinating and genital or anal discharge. If the infection spreads to the joints, it can result in gonococcal arthritis, causing swelling and discomfort.

Gonococcal arthritis typically affects the:

  • knees
  • ankles
  • wrists
  • elbows

If a DGI spreads to tissues other than the joints, it can cause other symptoms, which may include:

  • joint pain
  • fever
  • chills
  • malaise
  • tendon inflammation causing pain in the hands or wrists
  • skin lesions

Without treatment, gonococcal arthritis may lead to joint damage and persistent joint pain. An untreated DGI may rarely lead to other conditions or complications, such as:

  • meningitis
  • endocarditis
  • osteomyelitis
  • vasculitis

Other complications related to gonorrhea are also possible without treatment.

In males, for example, untreated gonorrhea can cause the tubes attached to the testicles to become inflamed and painful. The CDC notes that in rare cases, this may lead to them becoming sterile.

In females, untreated gonorrhea may also lead to pelvic inflammatory disease (PID). PID itself is associated with complications such as:

  • infertility
  • long-term pelvic pain
  • ectopic pregnancy
  • scar tissue that blocks the fallopian tubes

People with untreated gonorrhea may also have a higher chance of contracting or transmitting HIV. This may be due to the higher risk of having open sores, which can make it easier for viruses and bacteria to enter the body.

Diagnosing gonococcal arthritis involves ruling out other causes and confirming the presence of gonorrhea. Doctors will perform a physical examination and ask the person about their symptoms.

They may also order a number of tests to check for gonorrhea and to determine any complications or damage to tissues.

Tests may include:

  • tests to check for inflammatory markers
  • white blood cell count
  • testing joint fluid for bacteria
  • blood culture test
  • imaging tests

Once a doctor confirms gonorrhea and any presence in the joints, they will suggest beginning antibiotic treatment.

People may mistake gonococcal arthritis for other forms of arthritis, such as reactive arthritis.

Similar to gonococcal arthritis, reactive arthritis refers to joint inflammation triggered by an infection in another part of the body.

However, reactive arthritis may occur alongside other symptoms, such as inflammation in the eyes and urinary tract. Inflammation of the joints, urethra, and eyes makes up the characteristic triad of symptoms of reactive arthritis. They do not occur with gonococcal arthritis.

Reactive arthritis will not occur with dermatitis, whereas gonococcal arthritis may cause these skin symptoms. Additionally, reactive arthritis may have a longer, slower onset. Gonococcal arthritis symptoms may appear more suddenly.

Reactive arthritis can occur due to STIs, such as chlamydia, but not due to gonorrhea. Other infections — such as salmonella, shigella, and campylobacter infections — may also lead to reactive arthritis.

Treating gonococcal arthritis involves first treating gonorrhea. Doctors typically treat gonorrhea with antibiotics. A 2020 article notes that ceftriaxone is the preferred initial antibiotic.

Additionally, some doctors may suggest using other antibiotics, such as azithromycin, cephalosporin, or doxycycline.

In people with complications such as gonococcal arthritis, the full course of treatment may involve a 7–14-day round of antibiotics.

Because gonorrhea is an STI that people can acquire through sexual activities, a doctor may recommend that a person contacts any sexual partners from the past 2 months and suggests that they test for gonorrhea. This may help limit the spread of the infection.

Preventing gonococcal arthritis involves taking steps to prevent gonorrhea. The only way to completely avoid STIs such as gonorrhea is to avoid any form of sexual activity.

The CDC notes that people who are sexually active can take steps to lower the chances of acquiring gonorrhea. These steps include using condoms during any sexual activity and being in a long-term sexual relationship with one person who does not have gonorrhea.

Regularly testing for gonorrhea and other STIs can also help reduce the spread. This is most important for sexually active people — especially those who have sex with multiple partners. Undergoing a yearly screening for gonorrhea and other STIs may also help reduce the spread.

Gonococcal arthritis refers to inflammation that occurs in a joint due to a gonorrhea infection. Untreated gonorrhea infections can spread to distant tissues, such as the joints, and may lead to complications such as gonococcal arthritis.

Treating gonorrhea will treat gonococcal arthritis, though it may require a longer course of antibiotics. Contacting previous sexual partners and suggesting that they test for gonorrhea is an important part of controlling the spread of this infection.

With prompt antibiotic treatment, the gonococcal infection should clear.