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Septicemia Caused by Penicillinase-Producing Gonococcus

P. Ruutu, MD; R. Rajala, MD; H. Repo, MD; P. Hirvonen, MD; J. Lähdevirta, MD
JAMA. 1984;251(14):1836-1840. doi:10.1001/jama.1984.03340380022016.
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To the Editor.—  We would like to continue the interesting discussion by Doraiswamy et al1 and Alfonso et al2 about infections caused by penicillinase-producing strains of gonococci (PPNG) by presenting a case of PPNG bacteremia.

Report of a Case.—  A 36-year-old man has been treated for ten years with β-blockers and prazosin hydrochloride for moderate hypertension. He had gonococcal urethritis in the late 1960s and early 1980s.From mid-February 1983, the patient had a sore throat, with no response to potassium phenoxymethyl penicillin given orally. On Feb 26, he had fever (39.5 °C), noticed pustulelike lesions on the dorsum of his right hand, left upper arm, and the dorsum of both feet, and was admitted to Aurora Hospital. Leukocyte count in the peripheral blood was increased (2.4×1010/ L), with a mild shift to the left. Cerebrospinal fluid drawn because of headache yielded marginally elevated levels of erythrocytes


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