The California Department of Public Health (CDPH) and the Orange County Health Care Agency have been receiving increased reports of disseminated gonococcal infection (DGI). DGI is an uncommon but severe complication of untreated gonorrhea. DGI occurs when the sexually transmitted pathogen Neisseria gonorrhoeae invades the bloodstream and spreads to distant sites in the body leading to clinical findings such as septic arthritis, polyarthalgia, tenosynovitis, petechial and pustular skin lesions, bacteremia and on rare occasion endocarditis or meningitis.
DGI is commonly underdiagnosed due to the frequently asymptomatic nature of mucosal infection sites (urogenital, rectal, pharyngeal) and often negative culture results from disseminated infection sites (blood, synovial fluid, cerebral spinal fluid, skin).
If you have a case suspicious for DGI:
- Collect NAAT and culture specimens from urogenital and extragenital sites (rectal, pharyngeal).
- Collect culture specimens from disseminated sites of infection (skin, synovial fluid, blood or CSF).
- All gonorrhea isolates in DGI cases should be tested for antibiotic susceptibility which requires culture.
- Please make arrangements with your laboratory to send all DGI isolates to the Orange County Public Health Lab. We will forward the isolates to the CDC (Center for Disease Control) for whole genome sequencing.
CDPH has a DGI webpage including FAQs for Health Care Providers,
