Gonococcal meningitis and gonococcal endocarditis are rare but serious complications of disseminated gonococcal infection (DGI). These invasive presentations carry significant clinical severity and require a treatment approach distinct from uncomplicated gonorrhoea.
This protocol applies when gonorrhoea has disseminated to cause central nervous system involvement (gonococcal meningitis) or cardiac infection (gonococcal endocarditis) — among the most severe recognised presentations of DGI.
These severe invasive presentations require parenteral antibiotic therapy. Treatment duration is extended considerably compared with uncomplicated gonorrhoea, and differs depending on whether meningitis or endocarditis is the primary complication.
A number of other rare but serious clinical presentations of DGI have been reported including pericarditis, vasculitis, endocarditis and meningitis.
For gonococcal meningitis and endocarditis, parenteral therapy with ceftriaxone 1–2 g IV every 12–24 h should be continued for 10–14 days for meningitis and at least 4 weeks for endocarditis.
DOI: 10.1177/09564624251345195 View source ↗