Gonorrhea

Gonorrhea is a very contagious sexually transmitted disease (STD). It is one of the most common venereal diseases in the world. It can be successfully treated with antibiotics, but without prompt treatment, sterility may occur. In addition, it may also cause congenital blindness.

The gonorrhea bacterium (Neisseria gonorrhoeae) is the cause of the disease. It causes inflammation of the mucous membranes of the urogential tract. They may also affect the membranes of the throat, the conjunctiva, and the rectum. These infections are most likely if the infected person has engaged in oral or anal sex.

Gonorrhea infections of the throat (gonoccal pharyngitis) can cause a sore throat, but often the infection is asymptomatic. Diagnosis can be made with a throat culture. In cases of rectal gonorrhea (gonococcal proctitis), symptoms may include anal discharge, pain on defecating, and rectal bleeding.

The gonorrhea bacterium usually infects the columnar epithelium of the urethra and the endocervix. Symptoms of gonorrhea in men are a thick yellow-green discharge from the penis. The symptomatic discharge can occur as early as two days after infection but usually no later than 14 days after infection. Most case present symptoms within two to five days after infection. In addition, the urethra will also be inflamed which will cause significant pain in urinating. Urination will be slow and difficult. In a small number of males, no symptoms are presented; however, they become carriers who can infect their sexual partners.

In women, the cervix is usually the first place infected. Symptoms of gonorrhea are often absent which will allow infection of new partner(s) in future sexual encounters. In some females, symptoms do develop. These are usually slowly presented as vaginal discharge, painful urination, frequent urination, or pain in the lower abdomen.

Infection with gonorrhea may occur in the throat or rectum. Symptoms are asymptomatic. Discovery of the disease occurs only with coincidental medical tests.

Diagnosis of gonorrhea for males is made with a Gram's stain test of the urethral discharge. The diagnosis is reliable in men. It can be performed in a physician's office with a sample of the patient's discharge. However, the test is not as reliable in women because gonorrhea bacteria can be confused [Page 747]with other naturally occurring organisms in the vagina or uterus. Definitive diagnosis in women is made with a culture. New testing techniques examine the genes of the bacteria from a urine or cervical swab. This test is somewhat more accurate than the culture method.

Treatment for gonorrhea with antibiotics is usually successful. However, successful treatment will not protect against reinfection through subsequent sexual contacts. Resistant strains of the gonorrhea bacteria since the 1970s have rendered penicillin and tetracycline ineffective. The problem of resistance is a continuing problem that threatens vast numbers of people globally. The Centers for Disease Control and Prevention declared gonorrhea bacterium a “super bug” in 2007.

Antibiotics now used to treat gonorrhea include fluoroquinolones, spectinomycin, amoxycillin, ampicillin, and others. If the patient is pregnant, fluoroquinolones cannot be used.

There are no known home cures for gonorrhea. Treatment has to be made by a physician. In addition all sexual partners must be identified to its further spread.

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