Maj Svanbom

Benign Gonococcemia with Skin Lesions and Arthritis

Abstract An account is given of 16 cases of benign gonococcemia during the period Dec. 1, 1967 to Oct. 31, 1969. 15 patients were women, 1 man, and the average age was 29 years. The typical clinical picture consisted of fever, joint affection combined with a vesiculopapular, frequently hemorrhagic exanthema and genital gonococcal infection with usually slight or no symptoms and a good general condition throughout. Neisseria gonorrhoeae was isolated from the blood in 1 case. Positive cultures were more frequently obtained from the genital and anal mucous membranes. With the fluorescent antibody technique gonococci were demonstrated from an efflorescence of 1 patient. Serological response was demonstrated in 8 patients. All cases had an unequivocal clinical picture. Penicillin resistance did not occur, but a reduction in sensitivity was noted in 1 case. Treatment had prompt effect, but spontaneous healing was also seen. No complications or relapses were noted.

Prediction of Staphylococcal Etiology among Patients with Septicemia with or without Endocarditis by Multivariate Statistical Methods

Multivariate statistical methods, multiple regression (RA) and automatic interaction detector analysis (AID) were used to study the possibility of an early prediction of staphylococcal etiology in 249 of 851 patients with verified septicemia or endocarditis. The variables included pertinent symptoms and signs and laboratory data available soon after admission. 10 of the 70 variables initially studied showed simple, or in various combinations, a statistically significant partial correlation to staphylococcal etiology in the AID. The highest predictive value with a high probability for staphylococcal etiology was recorded for combinations of the variables: i.v. narcotic addiction and septic pulmonary embolism; non-addiction, wound infection, and hospitalization within 4 weeks; non-addiction, absence of skin infection, presence of foreign body, and age less than 60 yr. Staphylococcal etiology was contradicted by the absence of i.v. narcotic addiction, skin infection, foreign body, septic skin manifestation, surgical procedure within 4 weeks, joint symptom and a C-reactive protein less than or equal to 10 mm. Thus, a prediction of etiology may be valuable in choosing therapy before definite confirmation by positive blood cultures or when blood cultures remain sterile.