In recent years attention has been drawn to the gonococcal dermatitis syndrome, characterized by intermittent fever, arthralgia, and a hemorrhagic vesiculopustular cutaneous eruption. This syndrome is associated with genitourinary gonorrhea. The skin lesions have been thought to be caused by bacterial embolization accompanying a transient gonococcemia, but there has been little firm evidence to support this concept.
Two cases of the gonococcal dermatitis syndrome are reported. Gonococci were isolated from blood and joint fluid in one patient and from a cervical discharge of the other. Gonococci were demonstrated in skin lesions of both patients by employing fluorescent antibody techniques, but not by Gram's stain. Immunofluorescence of histopathologic sections showed gonococci and gonococcal antigens, not noted with routine staining; the antigen was located around blood vessels of a skin lesion.
Kahn G, Danielsson D. Septic Gonococcal DermatitisDemonstration of Gonococci and Gonococcal Antigens in Skin Lesions by Immunofluorescence. Arch Dermatol. 1969;99(4):421-425. doi:10.1001/archderm.1969.01610220049008