Gonorrhea is a common sexually transmitted infection caused by the gram-negative diplococcus Neisseria gonorrhoeae. Symptoms of gonorrhea in women include vaginal discharge, dysuria, intermenstrual bleeding, dyspareunia and abdominal pain. In men, gonorrhea causes anterior urethritis.
Gonorrhea may cause lower abdominal pain as well as pain in bowel movements.
Although rare, if left untreated, gonorrhea may produce endocarditis and valvular dysfunction .
It may cause skin lesions and rash.
Central nervous system (CNS)
Gonorrhea may cause meningitis.
It may cause an infection in the joints making them swollen and painful .
If left untreated, gonorrhea may lead to:
The workup includes blood sampling for culture and sensitivity. A swab sample of fluids may be collected from the throat, cervix, vaginal canal and/or rectum in females and throat, penile urethra and/or rectum in males .
Gram staining: Gram staining may be done to check for the organism involved.
PCR: A Polymerase Chain Reaction test maybe done for more accurate results.
C/S: Culture and sensitivity of either blood samples, urine or swab samples may be done for accurate results.
If the test results come positive, treatment is immediately started.
Other STDs are also checked.
Treatment is either oral or parenterally administered antibiotics. The common regime used these days is Ceftriaxone, Azithromycin and Doxycycline given in a combination to prevent reoccurrence as well as to treat other STDs like Chlamydia, if also present .
If treated with proper antibiotics, most commonly used are a Cephalosporin (Ceftriaxone) in combination with a macrolide (Azithromycin) and Doxycycline, the disease shows a positive response. Symptoms regress in just a few days of antibiotic treatment and completely disappear after some time. This 3-antibiotic regime is given to ensure reinfection may not occur as well as any other STD, like Chlamydia, may also be treated if present.
The causative agent of this disease is the bean-shaped coffee coloured spherical bacteria called Neisseria gonorrhoea that occurs as pairs, hence called diplococci. It is a facultative anaerobe and grows in abundance in moist, warm mucus membranes of the body. So when contracted, the bacterium quickly settles and multiplies in the vaginal canal, cervix, uterus and uterine tubes, penile urethra, rectum and/or oral cavity.
This bacteria is transmitted in two major ways:
This is the most common mode of transmission. An individual may knowingly or unknowingly transmit the bacteria to his or her sexual partner by either oral, vaginal or anal sex . Depending upon the kind of intercourse performed, the bacteria may start an infection in that area. For example, anal sex leads to development of gonorrhoea primarily in the rectum, oral sex leads to infection in the throat, etc.
A pregnant female may transmit this disease to her baby, particularly at the time of cord clamping, because an exchange of infected fluids may occur at that time. Or, the child may become infected when passing through the bacteria-laden birth canal during labor.
It is a common, but a completely wrong belief that gonorrhoea can be transmitted by using public toilets. This is a myth.
African-Americans are known to be the most susceptible, and so majority of the cases of gonorrhoea are found in people of this race.
Although gonorrhea can occur at any age; neonatally if transmitted from infected mother to baby, or post-puberty via unprotected sexual activity, it is most commonly found in young individuals ranging from 15 years to 25 years.
Gonorrhea occurs in both men and women, but females have a higher rate of incidence than men.
According to the Centre of Disease Control, more than 800.000 people in the United States get gonorrhea each year. Worldwide, it is estimated by WHO that over 62 million cases occur annually.
As discussed above, by having unprotected sex with an infected individual, one can contract this disease. The invading bacteria have specialised surface proteins called Opa proteins that possess the capability to bind with immune complex receptors. Upon binding, they render the immune complexes nonfunctional and thus they colonise the mucus membranes of the body without any opposing mechanisms. Once settled, they begin multiplying and after an incubation period of 2-14 days, symptoms present .
Although some people remain symptomless at first, many develop characteristic signs. Such as:
In females, it presents with milder symptoms and can be confused with pelvic inflammatory disease or yeast infections. Once infection begins, it may spread via the bloodstream to different parts of the body and may cause systemic effects.
Gonorrhea, like other STDs can be easily prevented. Preventive measures include :
N. gonorrhoea, or gonococcus, is a gram negative bacteria. It is a bean shaped diplococcus that is a facultative intracellular anaerobe. There are a total of 11 species of Neisseria known to have humans as a host, out of which only two are harmful to us. Many are a part of the normal flora of the body, except gonococci which cause gonorrhea and meningococci, which cause meningitis . Easily cultured on chocolate agar, this bacteria can be easily isolated and tested.
N. gonorrhoea has special Opa proteins on its surface which bind to receptors present on the immune complexes making them non-functional . This prevents both an immunological response by the host against the pathogen as well as the formation of immune memory of that particular invader.
Gonorrhea presents with characteristic symptoms in most cases, but in some patients it may be symptomless at first. The disease can occur in the throat, in the genitals and the rectum. However, gonorrhoea does have extra-urogenital manifestations which will be talked about in detail in later segments.
Gonorrhea is a sexually transmitted disease caused by a bacterium called Neisseria gonorrhoea.
It can be transmitted by having unprotected vaginal, oral or anal sex with an infected partner. It can also be transmitted by infected mother to her baby during childbirth. In this case, early detection of the disease can protect the baby.
Signs and symptoms
Common symptoms include pelvic pain, greenish yellow or white discharge, swollen genitals and burning in urination.
Treatment is antibiotics and a sex-free period till the disease is cured.
It can be easily prevented by taking the right precautionary measures like using latex condoms during intercourse, screening and testing for STDs once a year and not having multiple sexual partners.