Gonococcus

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