Gonorrhoea – Causes, Symptoms and Treatment
Gonorrhoea is a bacterial sexually transmitted infection caused by Neisseria gonorrhoeae. It affects mucous membranes and is one of the most common STIs worldwide.
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Gonorrhoea is a bacterial sexually transmitted infection caused by Neisseria gonorrhoeae. It affects mucous membranes and is one of the most common STIs worldwide.
What is Gonorrhoea?
Gonorrhoea (also spelled gonorrhea) is a bacterial infectious disease caused by the bacterium Neisseria gonorrhoeae. It is one of the most commonly reported sexually transmitted infections (STIs) globally and primarily affects the mucous membranes of the urinary tract, genitals, rectum, throat, and eyes.
Causes and Transmission
Gonorrhoea is transmitted through unprotected sexual contact, including vaginal, anal, and oral sex. It can also be passed from mother to newborn during childbirth, potentially causing a serious eye infection known as ophthalmia neonatorum.
- Unprotected vaginal, anal, or oral sex
- Sharing sex toys without protection
- Mother-to-child transmission during birth
People with multiple sexual partners, those who do not consistently use condoms, or those who already have another STI are at higher risk of infection.
Symptoms
Symptoms vary depending on the site of infection and the sex of the individual. A significant proportion of infections – particularly in women – may be asymptomatic initially.
Symptoms in Men
- Purulent (pus-like) discharge from the penis
- Burning sensation or pain during urination
- Redness and swelling at the urethral opening
Symptoms in Women
- Changed or purulent vaginal discharge
- Burning or pain during urination
- Pelvic or lower abdominal pain (if the infection spreads)
- Irregular vaginal bleeding
Symptoms at Other Sites
- Rectal gonorrhoea: discharge, itching, pain during bowel movements
- Pharyngeal gonorrhoea (throat): usually asymptomatic, occasionally sore throat
- Conjunctival gonorrhoea (eyes): redness, swelling, purulent discharge
Complications
If left untreated, gonorrhoea can lead to serious health complications:
- Pelvic Inflammatory Disease (PID): inflammation of the uterus, fallopian tubes, and ovaries – can lead to infertility
- Epididymitis: inflammation of the epididymis in men, also carrying a risk of infertility
- Disseminated Gonococcal Infection (DGI): spread of bacteria into the bloodstream, causing joint pain, skin rash, and in rare cases, endocarditis
- Increased susceptibility to HIV infection
Diagnosis
Diagnosis is typically made through laboratory testing:
- Nucleic Acid Amplification Test (NAAT): a highly sensitive molecular test performed on swabs or urine – the current gold standard
- Culture: growing the bacteria from a swab sample, important for antibiotic resistance testing
- Microscopy: Gram staining of a swab – useful in symptomatic men, less sensitive in women
Swabs can be taken from the urethra, cervix, rectum, throat, or eye depending on the sites at risk.
Treatment
Gonorrhoea is treated with antibiotics. Due to increasing antibiotic resistance, international guidelines currently recommend combination therapy:
- Ceftriaxone (intramuscular injection) as the first-line treatment
- Combined with azithromycin or doxycycline if co-infection with chlamydia is suspected or confirmed
A test of cure should be performed after treatment to confirm successful eradication. All sexual partners from the past 60 days should be notified, tested, and treated accordingly.
Prevention
- Consistent use of condoms during sexual activity
- Regular STI testing for individuals with multiple sexual partners
- Open communication with sexual partners about STI status
- Neonatal eye prophylaxis at birth (Crede prophylaxis)
References
- World Health Organization (WHO): Gonorrhoea (Neisseria gonorrhoeae infection). WHO Fact Sheet, 2023. https://www.who.int/news-room/fact-sheets/detail/gonorrhoea-(neisseria-gonorrhoeae-infection)
- Centers for Disease Control and Prevention (CDC): Gonorrhea – CDC Detailed Fact Sheet. 2023. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm
- European Centre for Disease Prevention and Control (ECDC): Gonorrhoea – Annual Epidemiological Report. ECDC, 2022.
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Related search terms: Gonorrhoea + Gonorrhea + Gonorrhea