GONOCOCCAL ARTHRITIS: A STUDY OF 202 PATIENTS TREATED WITH PENICILLIN, SULFONAMIDES OR FEVER THERAPY

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Abstract
202 patients with gonococcal arthritis were treated by various methods. Treatment with the Kettering hypertherm resulted in recovery in 21 (63.6%) of 33 patients. Better results were obtained in patients treated during the acute stage. Sulfonamides were used in 140 patients with favorable results in 97 (69.3%) of patients. The duration of the disease did not have so great an effect upon the outcome as did the existence of previous episodes of arthritis. Only 43.1% of the patients with previous attacks responded favorably, whereas 81.2% without previous episodes did well. Moreover, there appeared to be a tendency toward a progressive decrease in the efficacy of the sulfonamides during the past few yrs. Penicillin was given to 32 patients of whom 23 (72%) recovered. Of those who were adequately treated, recovery occurred in 84%. As with sulfonamides, the previous episodes of arthritis had a greater bearing on the outcome than did the duration of the present symptoms. Penicillin is the drug of choice in the treatment of gonococcal arthritis. It is recommended that 2-5 million U. of penicillin, administered over a period of 5-10 days, be used. Sulfonamides may be tried first if desired, and should always be employed in patients who do not respond to penicillin. Fever therapy is probably the most efficacious form of therapy for patients who have a history of previous attacks of arthritis, but because of the dangers involved in such therapy it should be the last resort after penicillin and sulfonamides have failed.