Clinical Manifestations of Disseminated Infection Caused by Neisseria gonorrhoeae Are Linked to Differences in Bactericidal Reactivity of Infecting Strains

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Abstract
There were 29 patients with disseminated gonococcal infection classified into 2 clinical groups at the time of hospitalization: 13 with suppurative arthritis and 16 with only tenosynovitis, dermatitis or both. Patients with suppurative arthritis had significantly less tenosynovitis and dermatitis (P < 0.02). Strains of N. gonorrhoeae isolated from the 2 groups of patients were each repetitively tested in a bactericidal assay using fresh frozen sera obtained from 10 normal human volunteers. Although strains causing disseminated gonococcal infection in general are serum resistant, those isolated from patients with suppurative arthritis were significantly less resistant (P < 0.01) than those isolated from patients with only tenosynovitis and dermatitis. Differences in strains as reflected by variation in resistance to normal human sera may cause these strains to produce diverse clinical manifestations.