Gonorrhea affectes the mucocutaneous surfaces of the lower genitourinary tract, anus, and rectum, and the oropharynx. The most common presentation in males is a purulent urethral discharge. In females, cervical infection is most common and is often asymptomatic; if untreated, infection can spread to deeper structures with abscess formation and disseminated gonococcal infection (DGI).
Causes of Localized Infection
Gonorrhea is caused by the Neisseria gonorrhoeae bacteria. The infection is transmitted from one person to another through vaginal, oral, or anal sexual relations
Symptoms of Localized Infection
In males, symptoms usually appear two to seven days after infection but it can take as long as 30 days for symptoms to begin. Often, there are no symptoms for people infected with gonorrhea; 10 to 15 percent of men and about 80 percent of women may have no symptoms. People with no symptoms are at risk for developing complications to gonorrhea. These people also spread this infection unknowingly.
Symptoms of gonorrhea include:
- Pain in the abdomen
- Pain during sex
- Fever
- Heavy bleeding with periods
- Unusual discharge from the vagina
- A burning feeling when urinating
- Sore throat (for gonorrhea in the throat)
- Pain, discharge, and bleeding from the anus (for gonorrhea in the anus)
- Redness, itching, or discharges of the eyes (for gonorrhea in the eye)
Diagnosis
Clinical suspicion, confirmed by laboratory findings, i.e., presumptively by identifying gram-negative diplococci intracellularly in PMNs in smears, confirmed by culture.
Treatment
The Centers for Disease Control (CDC), recommends several treatment options which include:
- Ceftriaxone 125 mg IM in a single dose,
- Ciprofloxacin 500 mg orally in a single dose,
- Cefixime 400 mg orally in a single dose,
- Doxycycline 100 mg orally twice a day for 7 days
- Ofloxacin 400 mg orally in a single dose, PLUS Azithromycin 1 g orally in a single dose.
Patients who are unable to tolerate these treatments can be offered alternative pharmaceutical treatments.
Prevention
To prevent the spread of gonorrhea, use latex condoms and avoid oral sex. Gonorrhea is highly contagious, and yet may cause no signs or symptoms.
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