Gonorrhea history and symptoms: Difference between revisions

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* Decreased or abnormal urine stream may suggest stricture
* Decreased or abnormal urine stream may suggest stricture
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<gallery> Image:Gonorrhea penile discharge.jpg|Penile discharge in a patient with gonorrhea</gallery>
<gallery> Image:Gonorrhea penile discharge.jpg|Penile discharge in a patient with gonorrhea - Source: https://www.std.gov/</gallery>
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Female Genitourinary'''
| style="padding: 5px 5px; background: #DCDCDC;" | '''Female Genitourinary'''
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* Severe lower abdomen [[pain]] (if the [[infection]] spreads to the [[fallopian tubes]], [[ovaries]], [[endometrium]])
* Severe lower abdomen [[pain]] (if the [[infection]] spreads to the [[fallopian tubes]], [[ovaries]], [[endometrium]])
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<gallery> Image:Gonorrhea1.jpg| Gonococcal infection, purulent discharge of the cervix os </gallery>
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Gonococcal proctitis (Rectal)'''
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* Mild to sever sore throat
* Mild to sever sore throat
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<gallery> Image:Gonorrhea20.jpg|Gonococcal pharyngitis</gallery>
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| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Ophthalmia neonatorum]]'''
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Ophthalmia neonatorum]]'''
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* Eyelids swellings
* Eyelids swellings
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<gallery> Image:220px-Gonococcal_ophthalmia_neonatorum.jpg|Neonatal conjunctivitis</gallery>
<gallery> Image:220px-Gonococcal_ophthalmia_neonatorum.jpg|Neonatal conjunctivitis - Door CDC/ J. Pledger - This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #3766.Note: Not all PHIL images are public domain; be sure to check copyright status and credit authors and content providers.English | Slovenščina | +/−, Publiek domein, https://commons.wikimedia.org/w/index.php?curid=901973</gallery>
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Revision as of 19:50, 22 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2], Priyamvada Singh, MBBS [3]

Overview

It is critical to obtain a detailed and thorough sexual history from the patient. Specific areas of focus when obtaining a history from a patient include number and type of sexual partners, contraception use, and previous history of sexually transmitted diseases. The majority of women with gonorrhea are asymptomatic, while others have vaginal discharge, lower abdominal pain, or pain during sexual intercourse. Common symptom of gonococcal infection in men include urethritis, which is 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.[1][2][3][4] 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.[5]

History and Symptoms

History

It is critical to obtain a detailed and thorough sexual history from the patient. In patients with suspected sexually transmitted diseases, the following aspects of the patient's history should be sought:[1][2][3]

  • Number and type of sexual partners
  • Previous history of gonococcal infection or other sexually transmitted diseases
  • Past history of similar symptoms or STDs in patient and current or past partners
  • Type of contraception used
  • History of sexual assault
  • Reproductive history
    • Details of parity including any history of ectopic pregnancies
    • Timing of the last menstrual period
    • Assessing the possibility of pregnancy

Symptoms

Common urogenital and extragenital Infection

  • Between 30–60% of women with gonorrhea are asymptomatic or have subclinical disease.[6]
  • The incubation time varies from 2 to 14 days with most symptoms occurring between days 2 and 5 after being infected from an infected partner.
  • A small number of people may be asymptomatic for up to a year. They may be completely unaware that they have caught the disease, and therefore do not seek treatment. This increases the risk of complications and the chances of passing the infection on to another person.

Common symptoms of urogenital and extragenital gonococcal Infection may include the following:[1][2][3][4][7][8]

Type of Gonococcal Infection Symptoms Images[9][10]
Male Genitourinary
  • Thick, copious, white, yellow, or green colored discharge from penis
  • Burning and pain while urinating
  • Urinary frequency or urgency
  • Painful or swollen testicles
  • scrotal pain or swelling
  • Decreased or abnormal urine stream may suggest stricture
Female Genitourinary
Gonococcal proctitis (Rectal)
  • Often asymptomatic
  • Anal discharge
  • Pain on defecating
  • Rectal bleeding
  • Pruritus
  • Tenesmus
  • Bloody diarrhea
Gonococcal pharyngitis
  • Usually asymptomatic
  • Mild to sever sore throat
Ophthalmia neonatorum
  • Occurs within 2-5 days after birth
  • Severe white bilateral discharge
  • Tearing
  • Eyelids swellings

Disseminated gonococcal infection

Symptoms of disseminated gonorrheal infection may include the following:[11][12][5]

Type of Disseminated gonorrheal infection Symptoms Images[10][13]
Arthritis Dermatitis Syndrome
  • Asymptomatic genitourinary
  • Joint or tendon pain
  • Rash commonly found below neck, palm and sole
  • Fever
Septic arthritis
  • Abrupt onset of arthritis (Knees, wrists, and ankles)
  • Without skin lesion
Gonorrhea Meningitis
  • As a rare complications of DGI
  • Headache
  • Neck pain and stiffness
  • Fever
  • Decreased sensorium may indicate gonococcal meningitis
Gonorrhea Endocarditis
  • As a rare complications of DGI
  • Very rarely it may settle in the heart causing endocarditis
  • Fever and chills
  • Malaise
  • Atypical chest pain

References

  1. 1.0 1.1 1.2 Workowski KA, Bolan GA, Centers for Disease Control and Prevention (2015). "Sexually transmitted diseases treatment guidelines, 2015". MMWR Recomm Rep. 64 (RR-03): 1–137. PMID 26042815.
  2. 2.0 2.1 2.2 Sherrard J, Barlow D (1996). "Gonorrhoea in men: clinical and diagnostic aspects". Genitourin Med. 72 (6): 422–6. PMC 1195730. PMID 9038638.
  3. 3.0 3.1 3.2 Barlow D, Phillips I (1978). "Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects". Lancet. 1 (8067): 761–4. PMID 76760.
  4. 4.0 4.1 Osborne NG, Grubin L (1979). "Colonization of the pharynx with Neisseria gonorrhoeae: experience in a clinic for sexually transmitted diseases". Sex Transm Dis. 6 (4): 253–6. PMID 119330.
  5. 5.0 5.1 Rice PA (2005). "Gonococcal arthritis (disseminated gonococcal infection)". Infect Dis Clin North Am. 19 (4): 853–61. doi:10.1016/j.idc.2005.07.003. PMID 16297736.
  6. van Duynhoven YT (1999). "The epidemiology of Neisseria gonorrhoeae in Europe". Microbes Infect. 1 (6): 455–64. PMID 10602678.
  7. Stansfield VA (1980). "Diagnosis and management of anorectal gonorrhoea in women". Br J Vener Dis. 56 (5): 319–21. PMC 1045815. PMID 7427703.
  8. Kraus SJ (1Link title979). "Incidence and therapy of gonococcal pharyngitis". Sex Transm Dis. 6 (2 Suppl): 143–7. PMID 386537. Check date values in: |year= (help)
  9. STD Gonorrhea Infection Gallery http://www.std-gov.org/std_picture/gonorrhea_w.htm Accessed on September 22, 2016
  10. 10.0 10.1 Centers for Disease Control and Prevention. Public Health Image Library (PHIL) http://phil.cdc.gov/phil/details.asp Accessed on September 22, 2016
  11. Bleich AT, Sheffield JS, Wendel GD, Sigman A, Cunningham FG (2012). "Disseminated gonococcal infection in women". Obstet Gynecol. 119 (3): 597–602. doi:10.1097/AOG.0b013e318244eda9. PMID 22353959.
  12. O'Brien JP, Goldenberg DL, Rice PA (1983). "Disseminated gonococcal infection: a prospective analysis of 49 patients and a review of pathophysiology and immune mechanisms". Medicine (Baltimore). 62 (6): 395–406. PMID 6415361.
  13. STD Gonorrhea Infection Gallery http://www.std-gov.org/std_picture/gonorrhea_w.htm Accessed on September 22, 2016

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