Gonorrhea

Gonorrhea: Causes, Symptoms, and Treatment

Definition
Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It primarily affects the mucous membranes of the reproductive tract but can also infect the rectum, throat, and eyes. The infection is most commonly spread through unprotected sexual contact, including vaginal, oral, and anal sex.

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Causative Agent
Neisseria gonorrhoeae is a gram-negative bacterium that targets the mucous membranes of the genital tract, urethra, rectum, and throat. It thrives in moist, warm areas of the body, and it spreads through direct sexual contact with an infected person.

Transmission
Gonorrhea is highly contagious and spreads primarily through:

• Unprotected vaginal, oral, or anal sex with an infected person.
• Perinatal transmission: A pregnant woman can pass the infection to her baby during childbirth, potentially causing serious eye infections in newborns.

Etiopathogenesis
After entering the body, N. gonorrhoeae attaches itself to epithelial cells lining the mucous membranes of the reproductive tract, rectum, or throat. The bacterium multiplies and triggers an inflammatory response, which leads to tissue damage and the release of pus. In women, gonorrhea can spread to the uterus and fallopian tubes, causing pelvic inflammatory disease (PID), which may result in infertility if left untreated.

Manifestations
Gonorrhea can affect both men and women, but symptoms may vary between genders and can be asymptomatic in many cases, especially in women.

Symptoms in Men:

• Burning sensation during urination (dysuria)
• White, yellow, or green discharge from the penis
• Pain or swelling in one testicle (less common)

Symptoms in Women:

• Increased vaginal discharge
• Painful urination
• Vaginal bleeding between periods
• Pelvic or abdominal pain (especially if the infection has spread to the fallopian tubes)

Symptoms in Both Genders (if the infection affects other areas):

• Rectal infection: Anal itching, discharge, soreness, bleeding, or painful bowel movements.
• Throat infection: Sore throat, swollen lymph nodes, though often asymptomatic.
• Eye infection: If N. gonorrhoeae affects the eyes (usually from contact with infected genital fluids), it can cause redness, itching, and discharge.

Complications
If left untreated, gonorrhea can lead to serious health issues:

• Pelvic Inflammatory Disease (PID) in women: A serious infection that can cause chronic pain and infertility.
• Epididymitis in men: Inflammation of the epididymis, which can lead to infertility.
• Disseminated gonococcal infection (DGI): A rare but severe condition where the infection spreads to the bloodstream, causing joint pain, skin sores, and organ damage.

Diagnosis

• Nucleic acid amplification test (NAAT): The most common and sensitive test to detect N. gonorrhoeae in urine or swab samples from the affected area (cervix, urethra, rectum, or throat).
• Culture test: Bacterial cultures can be used to detect N. gonorrhoeae in more severe or complicated cases, especially in cases of antibiotic resistance.

Treatment
Gonorrhea is treatable, but due to increasing antibiotic resistance, treatment regimens may change.

Pharmacological Treatment:

• Antibiotics: The Centers for Disease Control and Prevention (CDC) currently recommends dual therapy with ceftriaxone (an injection) and azithromycin (oral). However, treatment guidelines may evolve as resistance patterns change.

Non-Pharmacological Measures:

• Abstaining from sexual activity during treatment to prevent spreading the infection.
• Partner notification and treatment: Ensuring that sexual partners are informed and treated is crucial to preventing reinfection and further spread of gonorrhea.

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Prevention Tips

• Consistent use of condoms during vaginal, oral, or anal sex to reduce the risk of transmission.
• Regular STI screenings for sexually active individuals, especially those with multiple partners.
• Open communication with sexual partners regarding STI status.
• Avoid sexual contact with infected individuals until they have completed treatment.

Early detection and treatment of gonorrhea are essential to prevent complications, reduce the spread of infection, and ensure a complete recovery. Responsible sexual practices and regular screenings can significantly lower the risk of contracting or transmitting this infection.

FAQs on Gonorrhea

1. What is gonorrhea?
Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae, affecting the genital tract, throat, and eyes.

2. How is gonorrhea transmitted?
Gonorrhea is primarily transmitted through unprotected sexual contact, including vaginal, anal, and oral sex, with an infected partner.

3. What are the symptoms of gonorrhea?
Symptoms include painful urination, abnormal discharge from the genitals, and, in women, pelvic pain. Some individuals may have no symptoms at all.

4. How is gonorrhea diagnosed?
Gonorrhea is diagnosed through laboratory tests, including urine samples or swabs from the affected areas, such as the cervix, urethra, throat, or rectum.

5. How is gonorrhea treated?
Gonorrhea is typically treated with antibiotics, usually a combination of an injection and oral medication, to clear the infection.

6. Can gonorrhea be prevented?
Yes, gonorrhea can be prevented by practicing safe sex, such as using condoms consistently and getting regular STI screenings, especially with new partners.

7. What happens if gonorrhea is left untreated?
If untreated, gonorrhea can lead to serious complications such as pelvic inflammatory disease (PID) in women, infertility, and an increased risk of HIV infection.