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Gonococcal Tenosynovitis-Dermatitis and Septic Arthritis-Reply

Sumner E. Thompson, MD; Norman F. Jacobs Jr, MD; Fernando Zacarias, MD; Michael F. Rein, MD; Jonas A. Shulman, MD
JAMA. 1981;246(9):940. doi:10.1001/jama.1981.03320090015015.
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In Reply.—  We regret our oversight in not including the double-blind trial of Trentham and colleagues in our reference list; it was a nicely done study. Our work is complimentary to theirs in that we have tried to define some time limits for treating this infection.We would disagree with Dr Masi's reasoning that because his results were "uniformly rapid"—we assume he means clinical response—that a shorter interval of intramuscular therapy would necessarily give equally good results. There are many examples of infections in which clinical improvement of the patient's condition is rapid, but failure to treat for a sufficient period of time leads to relapse. This could also occasionally be true in disseminated gonococcal infections if the primary site of infection is not the male urethra or the endocervix.Further investigation of the therapy of disseminated infections should probably not be spent in trying to find the minimal time


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