Identification of Disseminated Gonococcal Infection (DGI) Cases in Indiana

Indiana Health Alert Network Notification – Oct. 29, 2019

Identification of Disseminated Gonococcal Infection (DGI) Cases in Indiana

DGI is a rare but very serious complication of untreated Neisseria gonorrhoeae infection, occurring in up to 3% of gonorrhea cases. DGI occurs when this normally localized sexually transmitted infection enters the bloodstream and leads to serious complications including arthritis, endocarditis, and/or meningitis. DGI can cause irreversible damage to organ systems and can be life-threatening.

The Michigan Department of Health and Human Services (MDHHS) continues to investigate a cluster of what is now ten cases of DGI in southwest Michigan over the past 3 months. Two cases have now been identified northern Indiana. The Indiana State Department of Health (ISDH) is encouraging healthcare providers, especially those practicing in urgent care and hospital emergency departments, to consider DGI in the differential diagnosis, particularly if patients are experiencing symptoms, including:

 Fever or chills

 Feeling ill or generally unwell (malaise)

 Pain or swelling of the joints

 Pain in the tendons of the wrists or heels

 Skin rash with pink or red spots that become filled with pus

With the close proximity of DGI cases near the Indiana-Michigan border, patients may have sex partners in both jurisdictions or frequently travel between the two states. Providers assessing sexual history, along with symptoms, is beneficial for public health officials to identify links among DGI cases in the future.