What is Gonorrhea?
Gonorrhea, also known as “the clap,” is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. It primarily affects the mucous membranes of the reproductive and urinary tracts, including the cervix, urethra, rectum, throat, and eyes. The infection spreads through:
- Unprotected sexual contact (vaginal, anal, or oral)
- Blood transfusions (rare)
- Maternal transmission to newborns during childbirth
- Indirect contact with contaminated objects (e.g., towels, bedding)
Humans are the only natural hosts for N. gonorrhoeae. The bacteria thrive in moist, warm environments and cause inflammation via the release of toxins. Approximately 1 in 10 infected individuals show no symptoms, making it a silent epidemic.
Symptoms of Gonorrhea
Symptoms vary by infection site and gender. Many cases are asymptomatic, especially in women.
Common Symptoms:
- Men:
- Urethral discharge (yellow/green pus)
- Urinary urgency, dysuria (painful urination)
- Testicular pain/swelling (epididymitis)
- Women:
- Cervical/vaginal discharge
- Abdominal pain
- Irregular bleeding
- Often asymptomatic (silent infections)
- Other Sites:
- Throat infection: Sore throat, swollen glands
- Rectal infection: Anal itching, discharge, pain during bowel movements
- Disseminated gonorrhea: Fever, rash, joint pain/arthritis
How is Gonorrhea Diagnosed?
Diagnostic methods include:
- Nucleic Acid Amplification Tests (NAAT):
- Urine-based test for DNA detection
- Gold standard for asymptomatic cases
- Culture:
- Swab samples from infected sites (urethra, cervix, throat, rectum)
- Required for antibiotic susceptibility testing
- Gram Stain:
- Rapid microscopic examination of secretions
- Less sensitive than NAAT/culture
Testing guidelines recommend concurrent screening for chlamydia and other STIs. Pregnant women should be tested during early prenatal visits.
Treatment for Gonorrhea
Current guidelines recommend dual therapy due to rising antibiotic resistance:
- First-line treatment:
- Ceftriaxone 500mg intramuscular injection
- Plus Azithromycin 1g oral dose
- Important Considerations:
- Complete all medications even if symptoms resolve
- Avoid alcohol for 72 hours post-azithromycin
- Partner notification and simultaneous treatment
- Re-testing in 3 months to confirm cure
Resistance to older antibiotics (tetracyclines, fluoroquinolones) is now widespread globally.
Frequently Asked Questions (FAQ)
Can gonorrhea be cured?
Yes, with proper antibiotic treatment. However, incomplete treatment can lead to persistent infection and complications.
What happens if untreated?
Untreated infections can cause:
- Infertility (PID in women, epididymitis in men)
- Increased HIV transmission risk
- Disseminated gonococcal infection (DGI)
- Newborn blindness (ophthalmia neonatorum)
How long until symptoms appear?
Symptoms develop 2-10 days post-exposure. Some individuals remain asymptomatic indefinitely.
Can I get it again?
Yes – immunity is not developed. Safe sex practices are essential even after treatment.
Preventing Gonorrhea Infection
Key Strategies:
- Safe Sex Practices:
- Use condoms consistently for all sexual activities
- Limit number of sexual partners
- Regular Screening:
- Annual STI testing for sexually active individuals
- Testing after potential exposures
- Partner Communication:
- Notify partners of exposure for concurrent treatment
- Public Health Measures:
- Post-exposure prophylaxis for high-risk groups
- Newborn eye prophylaxis (silver nitrate)
