A difficult case of disseminated gonococcal infection

Abstract

A male patient in his forties with disseminated gonococcal infection presented to our hospital with the complaint of joint pain after sexual activity. The results of blood tests indicated inflammation, and Neisseria gonorrhoeae was isolated from a blood culture. We were unable to distinguish N. gonorrhoeae from Neisseria meningitidis solely on the basis of good growth on sheep blood agar after incubation for 24 h at 35°C in an atmosphere containing 5% CO₂ or on a positive result of a rapid antigen test using the N. meningitidis Y/W135 reagent of the PASTOREX Meningitis kit. We examined the immunological reactions of N. meningitidis using the PASTOREX Meningitis kit and evaluated the growth of seven N. gonorrhoeae and two N. meningitidis clinical isolates on sheep blood agar and chocolate agar. There was no difference in the growth on the two types of solid medium. However, four of the seven N. gonorrhoeae isolates showed weak agglutination with a sensitized latex reagent specific for N. meningitidis Y/W135. In conclusion, N. gonorrhoeae and N. meningitidis can be distinguished on the basis of the results of biochemical tests and/or mass spectrometry.