Culture-negative hand abscesses in immunocompetent individuals

Ho YMS, Sebastin SJ, Lim AYT
Correspondence: Dr Ho Yew Ming Samuel, lilming2000@gmail.com

ABSTRACT
T Gonococcal infection is a common sexually-transmitted infection in the older male population in our local setting. It is caused by Neisseria gonorrhoeae, and results in fever, dysuria and a foul-smelling discharge from the external urethral meatus. Occasionally, it may also present with disseminated gonococcal infection – dermatitis, septic arthritis and even meningitis or endocarditis. We present two unusual cases, where the primary presentation was that of multiple subcutaneous hand and wrist abscesses. This illustrates the need for competent history-taking, especially in culturenegative patients. We also recommend the use of gonococcal polymerase chain reaction tests in patients who demonstrate negative routine cultures, or in lieu of gonococcal culture when the diagnosis is equivocal or urgently required.

Keywords: disseminated gonococcal infection, gonococcal, hand abscesses, septic arthritis
Singapore Med J 2012; 53(2): e38–e39