Gonorrhea is a common human sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae.
The usual symptoms in men are burning with urination and penile
discharge.
Women, on the other hand, are asymptomatic half the time or have vaginal discharge and pelvic pain. In both men and women if gonorrhea is left untreated, it may spread locally causing epididymitis or pelvic inflammatory disease or throughout the body, affecting joints and heart valves.
Treatment is commonly with ceftriaxone as antibiotic resistance has developed to many previously used medications.
This is typically given in combination with either azithromycin or doxycycline, as gonorrhea infections may occur along with chlamydia, an infection which ceftriaxone does not cover.
Some strains of gonorrhea have begun showing resistance to this treatment, which will make infection more difficult to treat.
Most men who are infected have symptoms such as urethritis associated with burning with urination and discharge from the penis.
Either sex may also acquire gonorrhea of the throat from performing oral sex on an infected partner, usually a male partner. Such infection is asymptomatic in 90% of cases, and produces a sore throat in the remaining 10%.
The incubation period is 2 to 14 days with most of these symptoms occurring between 4–6 days after being infected.
Rarely, gonorrhea may cause skin lesions and joint infection (pain and swelling in the joints) after traveling through the blood stream.
Very rarely it may settle in the heart causing endocarditis or in the spinal column causing meningitis (both are more likely among individuals with suppressed immune systems, however).
Men have a 20% risk of getting the infection from a single act of vaginal intercourse with an infected woman. The risk for men who have sex with men is higher.
Women have a 60–80% risk of getting the infection from a single act of vaginal intercourse with an infected man.
A mother may transmit gonorrhea to her newborn during childbirth; when affecting the infant's eyes, it is referred to as ophthalmia neonatorum. It cannot be spread by toilets or bathrooms.
In those who fail initial treatment culture should be done to determine sensitivity to antibiotics. All people who test positive for gonorrhea should be tested for other sexually transmitted diseases such as chlamydia, syphilis and human immunodeficiency virus.
If not treated gonococcal ophthalmia neonatorum will develop in 28% of infants born to women with gonorrhea.
Gonorrhea if left untreated may last for weeks or months with higher risks of complications. One of the complications of gonorrhea is systemic dissemination resulting in skin pustules or petechia, septic arthritis, meningitis or endocarditis. This occurs in between 0.6 and 3.0% of women and 0.4 and 0.7% of men.
In men, inflammation of the epididymis (epididymitis); prostate gland (prostatitis) and urethral stricture (urethritis) can result from untreated gonorrhea.
In women, the most common result of untreated gonorrhea is pelvic inflammatory disease. Other complications include perihepatitis, a rare complication associated with Fitz-Hugh-Curtis syndrome; septic arthritis in the fingers, wrists, toes, and ankles; septic abortion; chorioamnionitis during pregnancy; neonatal or adult blindness from conjunctivitis; and infertility.
Neonates coming through the birth canal are given erythromycin ointment in the eyes to prevent blindness from infection. The underlying gonorrhea should be treated; if this is done then usually a good prognosis will follow.
Among persons in the United States between 14 and 39 years of age, 46% of people with gonorrheal infection also have chlamydial infection.
Women, on the other hand, are asymptomatic half the time or have vaginal discharge and pelvic pain. In both men and women if gonorrhea is left untreated, it may spread locally causing epididymitis or pelvic inflammatory disease or throughout the body, affecting joints and heart valves.
Treatment is commonly with ceftriaxone as antibiotic resistance has developed to many previously used medications.
This is typically given in combination with either azithromycin or doxycycline, as gonorrhea infections may occur along with chlamydia, an infection which ceftriaxone does not cover.
Some strains of gonorrhea have begun showing resistance to this treatment, which will make infection more difficult to treat.
Signs and symptoms
Half of women with gonorrhea are asymptomatic while others have vaginal discharge, lower abdominal pain or pain with intercourse.Most men who are infected have symptoms such as urethritis associated with burning with urination and discharge from the penis.
Either sex may also acquire gonorrhea of the throat from performing oral sex on an infected partner, usually a male partner. Such infection is asymptomatic in 90% of cases, and produces a sore throat in the remaining 10%.
The incubation period is 2 to 14 days with most of these symptoms occurring between 4–6 days after being infected.
Rarely, gonorrhea may cause skin lesions and joint infection (pain and swelling in the joints) after traveling through the blood stream.
Very rarely it may settle in the heart causing endocarditis or in the spinal column causing meningitis (both are more likely among individuals with suppressed immune systems, however).
Cause
Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. The infection is transmitted from one person to another through vaginal, oral, or anal sex.Men have a 20% risk of getting the infection from a single act of vaginal intercourse with an infected woman. The risk for men who have sex with men is higher.
Women have a 60–80% risk of getting the infection from a single act of vaginal intercourse with an infected man.
A mother may transmit gonorrhea to her newborn during childbirth; when affecting the infant's eyes, it is referred to as ophthalmia neonatorum. It cannot be spread by toilets or bathrooms.
Diagnosis
Traditionally, gonorrhea was diagnosed with gram stain and culture; however, newer polymerase chain reaction (PCR) based testing methods are becoming more common.In those who fail initial treatment culture should be done to determine sensitivity to antibiotics. All people who test positive for gonorrhea should be tested for other sexually transmitted diseases such as chlamydia, syphilis and human immunodeficiency virus.
Prevention
The risk of infection can be reduced significantly by using condoms correctly and by having a mutually monogamous relationship with an uninfected person. It may also be reduced by avoiding sexual intercourse.Prognosis
Gonorrhea if left untreated may last for weeks or months with higher risks of complications. One of the complications of gonorrhea is systemic dissemination resulting in skin pustules or petechia, septic arthritis, meningitis or endocarditis. This occurs in between 0.6 and 3.0% of women and 0.4 and 0.7% of men.
In men, inflammation of the epididymis (epididymitis); prostate gland (prostatitis) and urethral stricture (urethritis) can result from untreated gonorrhea.
In women, the most common result of untreated gonorrhea is pelvic inflammatory disease. Other complications include perihepatitis, a rare complication associated with Fitz-Hugh-Curtis syndrome; septic arthritis in the fingers, wrists, toes, and ankles; septic abortion; chorioamnionitis during pregnancy; neonatal or adult blindness from conjunctivitis; and infertility.
Neonates coming through the birth canal are given erythromycin ointment in the eyes to prevent blindness from infection. The underlying gonorrhea should be treated; if this is done then usually a good prognosis will follow.
Among persons in the United States between 14 and 39 years of age, 46% of people with gonorrheal infection also have chlamydial infection.
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