Those with underlying illness such as lupus, RA, renal failure, and diabetes may have gram-negative organisms. Gonococcal Arthritis Clinical features. May have an acute arthritis involving one or more joints, usually the knees, ankles, or wrists, with the knee being the most commonly involved. Two thirds of patients have a dermatitis with multiple, usually asymptomatic lesions that progress from macular to papular and finally vesicular, or pustular. Any new acute inflammatory monarthritis in a sexually active person should be considered related to gonococcal infection until proved otherwise.
Physical exam reveals an acute arthritis, synovitis, or tenosynovitis, or all three.
Blood cultures should be done as cultures of the throat, joint, anorectum, blood, and genitourinary tract should be. Nongonococcal Arthritis Clinical features. The acute onset of arthritis with a hot, swollen joint or joints. Generally one or two joints are involved. The knee is most commonly affected in adults, whereas the hip and knee are the most commonly involved joints in children.