15.15C: Gonorrhea

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Gonorrhea (also colloquially known as the clap) is a common human sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae.

Learning Objectives

Describe gonorrhea

Key Points

The usual symptoms of gonorrhea in men are burning with urination and penile discharge.
Women with gonorrhea, on the other hand, are asymptomatic half the time or have vaginal discharge and pelvic pain.
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.

Key Terms

ceftriaxone: A synthetic cephalosporin antibiotic used to treat gonorrhea.

Gonorrhea (also colloquially known as the clap) is a common human sexually transmitted infection. 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. In 2011, there were reports of some strains of gonorrhea showing resistance to ceftriaxone. Half of women with gonorrhea are asymptomatic while others have vaginal discharge, lower abdominal pain or pain with intercourse.

The most common male symptoms are 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 bacteria 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.

Figure: **Neisseria gonorrhoeae**: Neisseria gonorrhoeae cultured on two different media types and presented in stereoscopic 3d.