Gonococcal infection (Gonorrhea)

Overview

Gonorrhea, caused by the bacterium Neisseria gonorrhoeae, is a common sexually transmitted infection that can thrive in the mucous membranes of the body. It primarily spreads through sexual contact (vaginal, anal, or oral) and can also be transmitted from mother to newborn during childbirth.

Incubation period

The incubation period for gonorrhea typically ranges from 2 to 8 days. Symptoms may appear anywhere from 2 to 10 days after exposure to an infected individual, with women sometimes experiencing a delay of up to 3 weeks.

Clinical presentation

Men with gonorrhea have symptoms of urethritis, presenting with:

Purulent discharge: Thick, cloudy discharge from the urethra.
Dysuria: Pain or a burning sensation during urination.
Epididymitis or orchitis: Pain or swelling in the testicles.

It can also present as:
Pharyngitis: Symptoms such as swollen glands or a burning sensation in the throat.
Proctitis: Itching, bleeding, or pain during bowel movements.

Only about 10% of infections in men are asymptomatic.

Women may experience:

Cervicitis: Increased vaginal discharge and pain during urination.
Vaginal bleeding: Spotting between periods and after intercourse.
Pelvic pain: Discomfort in the lower abdomen and pelvic region.
Pharyngitis: Similar symptoms as in men.
Proctitis: Similar symptoms as in men.

Approximately 50% of women may be asymptomatic.

Complications

If left untreated, gonorrhea can lead to severe complications, particularly in women, including:

Pelvic inflammatory disease (PID): A serious infection of the reproductive organs that can cause chronic pain and infertility.
Ectopic pregnancy: A pregnancy that occurs outside the uterus, posing serious health risks.
Infertility: Potentially resulting from untreated infections.

There is also a risk of transmission to the newborn during delivery, which can lead to severe complications, including blindness.

In both genders, the infection can disseminate, resulting in:

Skin rash
Arthritis
Rare complications: Meningitis, endocarditis.

Diagnosis

Diagnosis of gonorrhea is typically confirmed through:

Gram staining: Direct microscopic examination.
Swabs: Identifying the bacteria in a laboratory setting.
Nucleic Acid Amplification Tests (NAATs): Highly sensitive methods for detecting the genetic material of the bacteria.

Routine screening for other STIs is also recommended.

Treatment

Gonorrhea is effectively treated with antibiotics. It is crucial that the sexual partners also undergo testing and treatment, even if they do not exhibit symptoms. Follow-up testing is necessary to ensure the infection has been eradicated, especially due to the potential for antibiotic resistance.

Patients are advised to abstain from sexual activity until treatment is complete and confirmed through follow-up testing.

For gonorrhea, it is typically recommended that all sexual partners from the last 60 days before the diagnosis should be tested and treated.

Conclusion

Understanding and addressing gonococcal infections promptly is essential for preventing complications and protecting sexual health.