Korean J Lab Med.  2011 Apr;31(2):118-121. 10.3343/kjlm.2011.31.2.118.

A Case of Bacteremia by Neisseria gonorrhoeae Coincident with Massive Hemorrhage of Esophageal Varices

• Won D
• An D
• Kim MN
• Lee YS

• KMID: 1094352
• DOI: http://doi.org/10.3343/kjlm.2011.31.2.118

Abstract

A 42-yr-old man with hepatitis B virus associated liver cirrhosis was admitted to the emergency room because of multiple seizures, a history of chills and myalgia over the previous 2 weeks, and 3 days of melena. He was febrile with a temperature of 38.0degrees C. There were no symptoms and signs related to the genitourinary system, skin, or joints. Three sets of blood cultures were obtained and oxidase-positive, gram-negative diplococci were detected after 25.9-26.9 hr of incubation in all aerobic vials. The organism was positive for catalase and oxidase, and was identified as Neisseria gonorrhoeae, using a Vitek Neisseria-Haemophilus Identification card (bioMerieux Vitek, Inc., USA). Further, 16S rRNA sequencing of this isolate revealed a 99.9% homology with the published sequence of N. gonorrhoeae strain NCTC 83785 (GenBank Accession No. NR_026079.1). Acute bleeding by variceal rupture seems to be a likely route of introduction of N. gonorrhoeae from the mucosa into the blood. To the best of our knowledge, this is the first case of gonococcal bacteremia in Korea.

Keyword

Neisseria gonorrhoeae; Bacteremia; Esophageal varices; Hemorrhage

MeSH Terms

Adult
Bacteremia/complications/*diagnosis/microbiology
Catalase/metabolism
Esophageal and Gastric Varices/complications/*diagnosis
Gastrointestinal Hemorrhage/*etiology
Gonorrhea/complications/*diagnosis/microbiology
Humans
Ligation
Liver Cirrhosis/diagnosis
Male
Neisseria gonorrhoeae/genetics/*isolation & purification
Oxidoreductases/metabolism
RNA, Ribosomal, 16S/chemistry/genetics
Sequence Analysis, DNA

Figure

• 

  Fig. 1 Colonies of Neisseria gonorrhoeae on chocolate (A) and blood agar plates (B) after a 2-day incubation.

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