Download PDF
CC BY 4.0 · Arch Plast Surg 2023; 50(02): 216-219
DOI: 10.1055/a-1938-0837
Communication

Flexor Tenosynovitis Caused by Neisseria gonorrhea Infection: Case Series, Literature Review, and Treatment Recommendations

Nirbhay Jain 
1   Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, California
,
Sean Saadat
1   Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, California
,
Mytien Goldberg
1   Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, California
2   Division of Plastic and Reconstructive Surgery, Harbor-UCLA Medical Center, Los Angeles, California
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Neisseria gonorrhoeae is the most common sexually transmitted disease in the world and is known to cause disseminated disease, most commonly tenosynovitis. Classically, gonorrhea-associated tenosynovitis presents with concomitant dermatitis and arthralgias, though this is not always the case. N. gonorrhoeae-related tenosynovitis has become more commonly seen by hand surgeons. To aid in management, we present three cases of gonorrhea-induced tenosynovitis spanning a range of presentations with variable treatments to demonstrate the variety of patients with this disease. Only one of our patients had a positive gonococcal screening test and no patient had purulent urethritis, the most common gonorrhea-related symptom. A separate patient had the classic triad of tenosynovitis, dermatitis, and arthralgias. Two patients underwent operative irrigation and debridement, and one was managed with anti-gonococcal antibiotics alone. Though gonorrhea is a rare cause of flexor tenosynovitis, it must always be on the differential for hand surgeons when they encounter this diagnosis. Taking an appropriate sexual history and performing routine screening tests can assist in the diagnosis, the prescription of appropriate antibiotics, and potentially avoiding an unnecessary operation.

Keywords

flexor tenosynovitis - gonorrhea - nonoperative management

Author Contributions

N.J., S.S., M.G. provided equal contribution to the formulation, analysis and writing of this article.


Patient Consent

All patients provided informed consent for participation in this study.




Publication History

Received: 24 February 2022

Accepted: 11 August 2022

Accepted Manuscript online:
07 September 2022

Article published online:
01 February 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA