What probably could've happened in the following case?
A healthy 27-year-old female presents with atraumatic joint pain and swelling. Over the past 4 days, she complains of the left knee, right wrist, and right ankle pain. She denies a rash or fever.
This type of arthritis is more commonly oligoarthritis than monoarthritis-although it has declined over the past decade, gonococcal arthritis remains the most common form of septic arthritis in the sexually active population, with a 4:1 female predominance. gonococcal arthritis is clinically and pathologically distinct from other bacterial infections and is less likely to create long-term joint pathology. this infection is more commonly oligoarthritis than monoarthritis, with the knee, ankle and wrist being the most commonly affected joints. diagnosis is difficult as both synovial and blood cultures are positive in only 10-50% of cases. however, synovial fluid often yields a positive grams stain. cervical, urethral, rectal and pharyngeal cultures are positive in up to 75% of cases and therefore should be cultured appropriately. treatment should be with a parenteral 3rd generation cephalosporin, with transition to oral antibiotics 24-48 hours after clinical improvement. (chapter 114)