Gonorrhea is a sexually transmitted infection which manifests as cervicitis, urethritis, proctitis, conjunctivitis and disseminated gonococcal infection
-It is caused by Neisseria gonorrhoeae, a gram-negative “kidney-bean” diplococcus typically found inside polymorphonuclear cells.
-Transmission in adults is by sexual contact, in neonates during the birth
Symptoms & Signs
Urethritis: Dysuria, purulent urethral discharge
Cervicitis: Increased vaginal discharge, urinary frequency, dysuria, abdominal pain
Rectal gonorrhea: pain, tenesmus, rectal discharge and bleeding Conjunctivitis: purulent discharge, blurred vision
Pelvic inflammatory disease: fever, abdominal pain, adnexal tenderness, infertility, ectopic pregnancy
Disseminated Gonococcal infection (DGI): Clinical triad of polyarthritis, tenosynovitis, and dermatitis
Classic skin lesion in DGI: A tender necrotic pustular lesion on an erythematous base
The most common cause of septic arthritis in young, sexually active adults: Disseminated gonococcal infection
Diagnosis
Gram smear, Culture (pharyngeal, urethral or cervical), Direct detection by nucleic acid amplification tests
Treatment
Gonorrhea and chlamydia treated together: Ceftriaxone plus azithromycin or doxycycline
All sexual partners should be treated