Reference no: EM132322059
A 17-year old girl was admitted to the hospital with a 1-week history of fever, chills, malaise, sore throat, skin rash, and polyarthralgia. She reported being sexually active and has a 5-week history of a profuse yellowish vaginal discharge, which was untreated. Upon presentation, she had erythematosus maculopapular skin lesions over her forearm, thigh and ankle, and her metacarpophalangeal joint, wrist, knee, ankle, and midtarsal joints were acutely inflamed. She had an elevated leukocyte count and sedimentation rate. Cultures of her cervix were positive for N. gonorrhoeae, but blood specimens, exudates for the skin lesions, and synovial fluid were all sterile.
What is the most likely cause of her polyarthritis?
a-Treponema pallidum
b-Neisseria gonorrhoeae
c-Staphylococcus aureus
d-Borrelia burgdorferi
e-Mycobacterium fortuitum
Why were the synovial fluid cultures negative?
a-It should have grown. The nurse mislabeled the sample.
b-The arthritis is a non-suppurative sequela
c-It should have grown. The lab made a critical mistake.
d-This organism cannot be cultured on artificial media
eThe organism is difficult to recover from synovial fluid beyond the first few days of inflammation.
What drug should be used for empiric treatment?
a-Ceftriaxone
b-Dicloxacillin
c-Vancomycin
d-Azithromycin
e-Penicillin