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Gonorrhea – What Should You Know About it?

January 5th, 2017

Gonorrhea – What Should You Know About it?

Gonorrhea – What Should You Know About it?

Gonorrhea is a sexually transmitted infection caused by bacteria, Neisseria gonorrhoeae. It is also known as “the clap” and can spread through all kinds of sexual intercourse with an infected partner (including, vaginal, anal, and oral). This disease is usually asymptomatic in most women. But, even if symptoms are experienced, the symptomatology is often mistaken for other vaginal and bladder infections.

In United States, each year nearly 820,000 people are diagnosed with this infection. The microorganism attacks the mucous membranes of reproductive organs including, vagina, cervix, fallopian tubes, endometrium, and urethra. It can also affect the throat, eyelid lining, anus, and rectum. Gonorrhea can spread even when the infected penis or tongue is not fully inserted inside the anus or vagina. A slight contact with infected secretions or semen is enough to cause harm! Sometimes, women can get infected without having sexual contact! For example, spread of infection from vagina to anus while wiping with toilet paper. Likewise, a hand to eye contact can result in the spread of infection into the eyelid lining. Moreover, gonorrhea can pass from mother to fetus via infected birth canal which causes pneumonia and eye infections in newborn. Gonorrhea never spreads through toilet seats or by shaking hands. A child infected with gonorrhea is an indication of sexual molestation.

Symptoms That Are Suggestive Of Gonorrhea

The symptoms of gonorrhea differ in both men and women. Usually men show symptoms within 2 to 5 days of exposure, which includes:

  • Painful or burning urination
  • Yellow-white penile discharge
  • Swollen and painful testicles
  • Increased frequency of urination

As discussed earlier, most of the time women remains asymptomatic. However, they might experience symptoms within 10 days after exposure. Possible symptoms include:

  • Unusual vaginal discharge which can be yellowish or with blood
  • Painful urination

Some women remain asymptomatic even when infection reaches to the fallopian tubes. Though, some will experience symptoms that are sign of gonorrhea advancing towards pelvic inflammatory disease. Symptoms include:

  • Pain in abdomen and lower back
  • Painful sex
  • Bleeding in between menstrual periods
  • Fever
  • Nausea

The rectal infections are mostly asymptomatic in both male and female. But if symptomatic, it may include:

  • Itching in rectum
  • Rectal discharge
  • Painful excretion

Most of the time, gonorrheal infections in mouth or throat are without symptoms. However, one may experience soreness in throat/mouth. Whereas, a person may have conjunctivitis if his/her eye is infected with gonorrhea.

An infected child will develop conjunctivitis and pneumonia within 5 to 12 days after birth. Untreated eye infections can lead to blindness.

Diagnosis Of Gonorrhea

Gonorrhea is diagnosed through a swab or urine test. Usually people are infected with both gonorrhea and chlamydia, simultaneously. Therefore, treatment is advised for both infections for best outcome.

Treatment

Gonorrhea Resistance – What Should You Know About It? image

Gonorrheal infection is treated through antibiotics. The treatment regimen includes two antibiotics because some gonorrhea strains develop antimicrobial resistance i.e. they are resistant towards certain antibiotics. It is important to strictly follow the regimen and one must get retested after completing the antibiotic course. If symptoms persist, culture testing should be doneagain. If drugs other than recommended regime is given, person should be re-examined after one week of treatment, regardless of whether symptoms persist or not. Moreover, infected person’s partner(s) must be examined as well.

Complications

Untreated gonorrhea may lead to serious complications.

Complication in men:

  • Prostatitis
  • Narrowed or closed urethral canal due to scarring of urethra
  • Epididymitis
  • Infertility

Complications in women:

  • Chronic menstrual problems
  • Pelvic inflammatory diseases
  • Miscarriages
  • Cystitis
  • Postpartum endometritis
  • Mucopurulent cervicitis

Disseminated Gonococcal Infection (DGI) occurs when gonorrhea disseminates into blood, skin, heart, and joints. It is characterized by:

  • Arthritis
  • Multiple skin lesions
  • Meningitis
  • Endocarditis

In children, meningitis, sepsis, and arthritis characterize it. Good thing is, DGI is curable.

Prevention

This disease can be avoided through:

  • Monogamous relation from both sides
  • Abstinence
  • Use of latex condoms
  • Use of non-lubricated condoms during oral sex

References

  • Gomez, G. B., Ward, H., & Garnett, G. P. (2014). Risk pathways for gonorrhea acquisition in sex workers: can we distinguish confounding from an exposure effect using a priori hypotheses?. Journal of Infectious Diseases, 210(suppl 2), S579-S585.
  • Balkus, J., Anzala, O., Kimani, J., Schwebkre, J., Lee, J., & Kabare, E. (2015, September). Periodic presumptive treatment for vaginal infections may reduce chlamydia and gonorrhea incidence: a secondary analysis from the Preventing Vaginal Infections Trial. In Brisbane: World STI and HIV Congress.

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