Gonorrhea Infection

Gonorrhea, also known as gonnococcal infection, gonococcal urethritis, gonorrhoea and the clap, is a sexually transmitted infection that is caused by the bacterium Neisseria gonorrhoeae. The usual symptoms in men are a burning sensation with urination and discharge from the penis. Women have no symptoms about 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 inflammation of the epididymis or pelvic inflammatory disease or throughout the body, affecting joints and heart valves.

Testing all women who are sexually active and less than 25 years of age each year is recommended. This same recommendation applies in men who have sex with men.

An estimated 88 million cases of gonorrhea occur each year, out of the 448 million new cases of all curable STI each year – that also includes syphilis, chlamydia and trichomoniasis. Infections in women most commonly occur when they are young adults. As of 2010, it caused about 900 deaths, down from 1,100 in 1990.

Signs and Symptoms 

Half of women with gonorrhea do not have symptoms, whereas others have vaginal discharge, lower abdominal pain, or pain with intercourse. Most infected men with symptoms have inflammation of the penile urethra associated with a burning sensation during urination and discharge from the penis. In men, discharge with or without burning occurs in half of all cases and is the most common symptom of the infection. Men and women can acquire gonorrhea of the throat from performing oral sex on an infected partner, usually a male partner. Such infection does not produce symptoms in 90% of cases, and produces a sore throat in the remaining 10%. In advanced cases, gonorrhea may cause a general feeling of tiredness similar to other infections. It is also possible for an individual to have an allergic reaction to the bacteria, in which case any appearing symptoms will be greatly intensified.

Causes

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. Below is the multiple view of a Neisseria gonorrhoeae bacterium which causes gonorrhoea.

Incubation Period 

The incubation period is 2 to 14 days, with most symptoms appearing between 4 and 6 days after infection. Rarely, gonorrhea may cause skin lesions and joint infection (pain and swelling in the joints) after traveling through the blood stream (see below). 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).

Spread

The infection is usually spread 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 that 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.

Among children it has been noted to spread through methods other than sex such as through contaminated objects. These objects have included baths, clothing, and towels. This however is very uncommon.

Diagnosis 

Traditionally, gonorrhea was diagnosed with gram stain and culture; however, newer polymerase chain reaction (PCR)-based testing methods are becoming more common. In those failing initial treatment, culture should be done to determine sensitivity to antibiotics. All people testing positive for gonorrhea should be tested for other sexually transmitted diseases such as chlamydia, syphilis, and human immunodeficiency virus.

Go to the next post for the treatment, prevention and prognosis of gonorrhoeae.