PEDIATRICS Vol. 53 No. 3 March 1974, pp. 436-440
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Neonatal Gonococcal Arthritis: Three Cases and Review of the Literature

Daniel P. Kohen M.D.1

1 Department of Pediatrics, U.S. Public Health Service Indian Hospital, Fort Defiance, Arizona

It is well known that gonorrhea is presently out of control, in fact pandemic, in many areas including many in the United States. On the Navajo Indian Reservation in Arizona and Western New Mexico, the incidence of gonorrhea is statistically higher than it is elsewhere in this country. For a population of 101,200 in 1970, the incidence of gonorrhea on the Reservation for fiscal 1970 was 2,480 per 100,000.1 In 1971 there were 2,564 new cases reported and on a revised population of 188,123, this is an incidence of 1,363 per 100,000 for fiscal 1971.2°

The Fort Defiance, Arizona Indian Hospital provides health services for an estimated 25,000 Navajos. In calendar year 1971 there were 363 new cases of gonorrhea reported there, an incidence of 1,452 per 100,000. With the resurgence of gonorrhea there has been increased reporting of pediatric gonococcal infections.37 In the year August 1971 to August 1972 three proven cases and one presumptive case of neonatal disseminated gonococcal infection were treated at the U.S. Public Health Service Indian Hospital in Fort Defiance. The three proven cases presented as neonatal gonococcal arthritis. A fourth case with a positive blood culture (cord blood) for Neisseria gonorrhoeae was also treated. The paucity of information on this disease, and its apparent rarity, stimulated this report.

CASE REPORTS

Case 1

V. K., a healthy, Apgar 10, 3,827-gm (8 lb, 7 oz) male infant was born on August 16, 1971, to a 20-year-old G2P1 Navajo woman after 40 weeks' gestation. Labor and delivery were complicated by PROM of 36 hours.




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