G163

Gram – Joint Fluid:

4+ (>10/oif) neutrophils, 3+ (11-50/oif) gram negative diplococci (Neisseria gonorrhoeae) – Shipped November 07, 2016

HISTORY

A simulated Joint Fluid smear collected from a 25 year old patient returning from Thailand was sent to category A, B, C, and C1 laboratories.
Participants were expected to report the presence of neutrophils and gram negative diplococci.

MAIN EDUCATIONAL POINTS from G163

  1. N. gonorrhoeae is an important cause of septic arthritis.
  2. Gram-staining of synovial fluid of non-gonococcal septic arthritis commonly reveals the causative bacterial pathogen; Gram-staining of synovial fluid septic arthritis caused by N. gonorrhoeae may not demonstrate the bacteria. It is therefore important to carry a high degree of suspicion when investigating monoarticular septic arthritis.

Full critique (PDF)

Posted in Clinical Bacteriology Results, critiques, Gram