Gonorrhea is a potential etiology of arthritis in a sexually active patient.
Disseminated gonococcal infection can include arthritis, arthralgias, tenosynovitis, perihepatitis, endocarditis and acral pustular lesions. Treatment for gonococcal infections both complicated and uncomplicated are with ceftriaxone and azithromycin. Using two agents with different mechanisms of action is thought to improve efficacy of treatment and may reduce emergence of resistance. The addition of azithromycin also adds coverage of C. trachomatis, a common co-infection.
Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137. PMID: 26042815