Gonorrhea (patient information)

For the WikiDoc page for this topic, click here

Gonorrhea
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Gonorrhea?
What to expect (Outlook/Prognosis)?
Possible complications
Gonorrhea On the Web
Ongoing Trials at Clinical Trials.gov
Images of Gonorrhea
Videos on Gonorrhea
FDA on Gonorrhea
CDC on Gonorrhea
Gonorrhea in the news
Blogs on Gonorrhea
Directions to Hospitals Treating Gonorrhea
Risk calculators and risk factors for Gonorrhea

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Alexandra M. Palmer

Overview

Gonorrhea is a common sexually transmitted disease (STD).

What are the symptoms of Gonorrhea?

Symptoms of gonorrhea usually appear 2 - 5 days after infection, however, in men, symptoms may take up to a month to appear. Some people do not have symptoms. 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. Symptoms in men include:

• Burning and pain while urinating
• Increased urinary frequency or urgency
• Discharge from the penis (white, yellow, or green in color)
• Red or swollen opening of penis (urethra)
• Tender or swollen testicles
• Sore throat (gonococcal pharyngitis)

Symptoms in women can be very mild or nonspecific, and may be mistaken for another type of infection. They include:

• Vaginal discharge
• Burning and pain while urinating
• Increased urination
• Sore throat
• Painful sexual intercourse
• Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and stomach area)
• Fever (if the infection spreads to the fallopian tubes and stomach area)

If the infection spreads to the bloodstream, fever, rash, and arthritis-like symptoms may occur.

What causes Gonorrhea?

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. Anyone who has any type of sex can catch gonorrhea. The infection can be spread by contact with the mouth, vagina, penis, or anus. The bacteria grow in warm, moist areas of the body, including the tube that carries urine out of the body (urethra). In women, the bacteria may be found in the reproductive tract (which includes the fallopian tubes, uterus, and cervix). The bacteria can even grow in the eyes. Health care providers in every state in the U.S. are required by law to tell their State Board of Health about anyone diagnosed with gonorrhea. The goal of this law is to make sure the patient gets proper follow-up care and that their sexual partners are found and tested. More than 700,000 persons in the United States get gonorrhea every year, according to the Centers for Disease Control and Prevention (CDC). Gonorrhea is more common in large cities, inner-city areas, populations with lower overall levels of education and people with lower socioeconomic status.

When to seek urgent medical care?

If you have symptoms suggestive of gonorrhea, you should call your health care provider immediately. Most state-sponsored clinics will diagnose and treat STDs without charge.

Who is at highest risk?

You are more likely to develop this infection if you:

• Have multiple sexual partners
• Have a partner with a past history of any sexually transmitted disease
• Do not use a condom during sex
• Are a man who has sexual contact with another man
• Have a drug addiction

Diagnosis

Gonorrhea can be quickly identified by staining a sample of tissue or discharge and then looking at it under a microscope. This is called a gram stain. Although this method is fast, it is not the most certain. Gram stain tests used to diagnose gonorrhea include:

• Cervical gram stain in women
• Gram stain of urethral discharge in men
• Joint fluid gram stain

Cultures (cells that grow in a lab dish) provide absolute proof of infection. Generally, samples for a culture are taken from the cervix, vagina, urethra, anus, or throat. Cultures can provide a preliminary diagnosis often within 24 hours and a confirmed diagnosis within 72 hours. Cultures used to diagnose gonorrhea include:

• Endocervical culture in women
• Urethral discharge culture in men
• Throat swab culture in both men and women
• Rectal culture in both men and women
• Culture of joint fluid
• Blood cultures

DNA tests are especially useful as a screening test. They included the ligase chain reaction (LCR) test. DNA tests are quicker than cultures. Such tests can be performed on urine samples, which are a lot easier to collect than samples from the genital area.

Where to find medical care for Gonorrhea?

Directions to Hospitals Treating Gonorrhea

What to expect (Outlook/Prognosis)?

A gonorrhea infection that has not spread to the bloodstream or other areas almost always can be cured with antibiotics. Gonorrhea that has spread is a more serious infection but almost always gets better with treatment.

Treatment options

There are two goals in treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infection in the patient. The second is to locate and test all of the other people the person had sexual contact with and treat them to prevent further spread of the disease. Never treat yourself without being seen by your doctor first. Your health care provider will determine the best and most up-to-date treatment. The U.S. Centers for Disease Control and Prevention (CDC) recommends the following treatments for uncomplicated gonorrhea.

• A single shot of ceftriaxone (Rocephin) 125 mg or a single dose of cefixime 400 mg taken by mouth are currently the recommended antibiotic treatment
• Azithromycin (Zithromax) 2g in a single dose may be used for people who have severe allergic reactions to ceftriaxone, cefixime, or penicillin.

Penicillin used to be the standard treatment, but it is not used any longer because it does not cure gonorrhea all the time. The CDC also recommends against using a class of antibiotics called fluoroquinolones (ciprofloxacin, ofloxacin, or levofloxacin). Persons with gonorrhea often also have a chlamydia infection. If a chlamydia culture was not done to rule out this infection, a single dose of azithromycin (1g by mouth) or doxycycline 100 mg twice a day, by mouth for 7 days should also be given. A follow-up visit 7 days after treatment is important if joint pain, skin rash, or more severe pelvic or belly pain is present. Tests will be done to make sure the infection is gone. All sexual contacts of the person with gonorrhea should be contacted and tested. This helps prevent further spread of the disease. In some places you may be able to take counseling information and medicines to your sexual partner yourself. In other places, the health department will contact your partner.

Possible complications

Complications in women may include:

• Salpingitis (scarring of the fallopian tubes), which can lead to problems getting pregnant or ectopic pregnancy
• Pelvic inflammatory disease
• Sterility (inability to become pregnant)
• Painful intercourse (dyspareunia)
• Pregnant women with severe gonorrhea may pass the disease to their baby while in the womb or during delivery

Complications in men may include:

• Scarring or narrowing of the urethra, the tube that carries urine out of the body
• Abscess (collection of pus around the urethra)
• Urination problems
• Urinary tract infection
• Kidney failure

Complications in both men and women may include:

• Disseminated infection, which can be very serious
• Long-term joint pain, if the infection is left untreated
• Heart valve infection
• Meningitis

Sexually transmitted diseases Main Page
Gonorrhea Microchapters
Home
Patient Info
Overview
Historical perspective
Classification
Pathophysiology
Causes
Differentiating Gonorrhea from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Antibiotic Resistance
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Gonorrhea (patient information) On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Gonorrhea (patient information) All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Gonorrhea (patient information)
CDC on Gonorrhea (patient information)
Gonorrhea (patient information) in the news
Blogs on Gonorrhea (patient information)
Directions to Hospitals Treating Gonorrhea
Risk calculators and risk factors for Gonorrhea (patient information)

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Overview

Gonorrhea (gonorrhoea in British English) is amongst the most common sexually transmitted diseases in the world and is caused by Gram-negative bacterium Neisseria gonorrheae. The term comes from Ancient Greek γονόρροια (gonórrhoia), literally "flow of seed"; in ancient times it was incorrectly believed that the pus discharge associated with the disease contained semen.

Prevention

Not having sexual intercourse (abstinence) is the only absolute method of preventing gonorrhea. A monogamous sexual relationship with an individual known to be free of any STD can reduce risk. Monogamous means you and your partner do not have sex with any other persons. You can greatly lower your risk of catching an STD by using a condom every time you have sex. Condoms are available for both men and women, but are most commonly worn by the man. A condom must be used properly every time. To further prevent the spread of infection, treatment of all sexual partners is important.

References

Template:WikiDoc Sources

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/007267.htm Template:WH Template:WS