Gonorrhea is a common sexually transmitted infection (STI).
Causes, incidence, and risk factors
Oral Gonorrhea |
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. Anyone who
has any type of sex can catch gonorrhea. The infection can be spread by contact
with the mouth, vagina, penis, or anus.
The bacteria grow in warm, moist areas of the body, including the tube
that carries urine out of the body (urethra). In women, the bacteria may be
found in the reproductive tract (which includes the fallopian tubes, uterus,
and cervix). The bacteria can even grow in the eyes.
Health care providers in every state in the U.S. are required by law to
tell their State Board of Health about anyone diagnosed with gonorrhea. The
goal of this law is make sure the patient gets proper follow-up care and that
their sexual partners are found and tested.
- You are more likely to develop this infection if you:
- Have multiple sexual partners
- Have a partner with a past history of any sexually transmitted infection
- Do not use a condom during sex
- Abuse alcohol or illegal substances
Symptoms
Symptoms of gonorrhea usually appear 2 - 5 days after infection,
however, in men, symptoms may take up to a month to appear. Some people do not
have symptoms. They may be completely unaware that they have caught the
infection, and therefore do not seek treatment. This increases the risk of
complications and the chances of passing the infection on to another person.
Symptoms in men include:
- Burning and pain while urinating
- Increased urinary frequency or urgency
- Discharge from the penis (white, yellow, or green in color)
- Red or swollen opening of penis (urethra)
- Tender or swollen testicles
- Sore throat (gonococcal pharyngitis)
Symptoms in women can be very mild or nonspecific, and may be mistaken
for another type of infection. They include:
- Vaginal discharge
- Burning and pain while urinating
- Increased urination
- Sore throat
- Painful sexual intercourse
- Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and stomach area)
- Fever (if the infection spreads to the fallopian tubes and stomach area)
If the infection spreads to the bloodstream, fever, rash, and
arthritis-like symptoms may occur.
Signs and tests
Gonorrhea can be quickly identified by staining a sample of tissue or
discharge and then looking at it under a microscope. This is called a gram
stain. Although this method is fast, it is not the most certain.
Gram stain tests used to diagnose gonorrhea include:
- Cervical gram stain in women
- Gram stain of urethral discharge in men
- Joint fluid gram stain
Cultures (cells that grow in a lab dish) provide absolute proof of
infection. Generally, samples for a culture are taken from the cervix, vagina,
urethra, anus, or throat. Cultures can provide a preliminary diagnosis often
within 24 hours and a confirmed diagnosis within 72 hours.
Cultures used to diagnose gonorrhea include:
- Endocervical culture in women
- Urethral discharge culture in men
- Throat swab culture in both men and women
- Rectal culture in both men and women
- Culture of joint fluid
- Blood cultures
DNA tests are especially useful as a screening test. They included the
ligase chain reaction (LCR) test. DNA tests are quicker than cultures. Such
tests can be performed on urine samples, which are a lot easier to collect than
samples from the genital area.
If you have gonorrhea, you should ask to be tested for other sexually
transmitted infections, including chlamydia, syphilis, and HIV. If you are 21
or older, you should be sure you have had a recent pap smear.
Treatment
There are two goals in treating a sexually transmitted disease,
especially one as easily spread as gonorrhea. The first is to cure the
infection in the patient. The second is to locate and test all of the other
people the person had sexual contact with and treat them to prevent further
spread of the disease.
Never treat yourself without being seen by your doctor first. Your
health care provider will determine the best and most up-to-date treatment.
About half of the women with gonorrhea are also infected with chlamydia,
another very common sexually transmitted infection. Chlamydia is treated at the
same time as a gonorrhea infection.
You should receive the hepatitis B vaccine. If you are younger than 26,
you also need the HPV vaccine.
A follow-up visit 7 days after treatment is important if joint pain,
skin rash, or more severe pelvic or belly pain is present. Tests will be done
to make sure the infection is gone.
All sexual contacts of the person with gonorrhea should be contacted and
tested. This helps prevent further spread of the disease. In some places you
may be able to take counseling information and medicines to your sexual partner
yourself. In other places, the health department will contact your partner.
Complications
Complications in women may include:
- Salpingitis (scarring of the fallopian tubes), which can lead to problems getting pregnant or ectopic pregnancy
- Pelvic inflammatory disease
- Infertility (inability to become pregnant)
- Pregnant women with severe gonorrhea may pass the disease to their baby while in the womb or during delivery
Complications in men may include:
- Scarring or narrowing of the urethra, the tube that carries urine out of the body (See: Urethral stricture)
- Abscess (collection of pus around the urethra)
- Complications in both men and women may include:
- Joint infections
- Heart valve infection
- Meningitis
Via PubMed Health
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