Gonorrhea is a sexually transmitted disease caused by gonococcal bacteria (Neisseria gonorrhoeae). See also Gonorrhea in women.
Causes and risk factors
Gonorrhea is one of the most common bacterial diseases, and transmission usually occurs during sexual intercourse both vaginal and anal or oral sex. Gonorrhea is a highly contagious disease, and all countries require communication to health authorities.
The incidence is 1 out of every 687 inhabitants per year.
Although gonorrhea occurs in all geographical areas and social classes, no uniform distribution in the population because it has a greater impact on:
- major urban areas.
- Populations with lower levels of education.
- People of lower socioeconomic status.
- People aged between 15 and 29 years.
- People with common sexual partners.
- Risk factors include having a partner with a past history of any STD and practice unprotected sex (sex without using a condom).
- In adolescents and children, transmission can occur by a non-sexual contact, but it is rare. In men, the risk of acquiring gonorrhea after a vaginal intercourse with an infected woman is approximately 20% (1 in 5 chance). In women, the risk of acquiring gonorrhea from an infected male is higher.
The average incubation period of gonorrhea is between 2 and 5 days after sexual contact with an infected partner. Symptoms may not appear until after 2 weeks.
The most common initial symptom is a urethral discharge (white or clear) or purulent (thick, yellowish) mucosa. It appears at the opening of the penis and may stain underpants. Other early symptoms include painful urination and burning sensation in the urethra. A small number of men have no symptoms.
Anorectal gonorrhea is more common in gay men (also found in approximately 50% of women with gonorrhea). Most of the people with anorectal gonorrhea have no symptoms but, if present, the most typical is proctitis.
A small percentage of people with gonorrhea have only strep throat (gonococcal pharyngitis).
10% to 25% of homosexual men (10 to 20% women) with gonorrhea also develop gonococcal pharyngitis.
Gonococcal conjunctivitis (eye infection) is very rare in adults. Usually only it occurs in newborns of mother with gonorrhea, and is called neonatal ophthalmia.
Gonorrhea is often associated with the presence of other sexually transmitted diseases (STDs).
Sexual abstinence is the only absolutely sure method to avoid gonorrhea, but not practical or reasonable for many people. Safe sex behaviors may reduce the risk. Sexual relationship with one person free of any ETS is currently the most acceptable preventive measure.
Condom use in both sexes significantly decreases the likelihood of getting an STD provided it is properly used: the condom must be put from the beginning to the end of the sexual act and should be used whenever sexual activity is practiced with a partner in which is suspected of an STD.
The treatment of the two components of the couple is essential to prevent reinfection, and is one of the reasons why this disease is notifiable. Gonorrhea is a relatively easy disease to cure and eradicate, because the germ causing only found on the mucous membranes of humans.
- Increased urinary frequency or urgency.
- urinary incontinence.
- Urethral discharge.
- Painful urination.
- Redness and itching of the opening of the penis (urethra)
- Swollen testicles.
- Analysis and test
- A preliminary diagnosis of gonorrhea can be done immediately during physical examination.
- A sample of urethral discharge is taken and examined under the microscope (using a technique known as Gram stain. Germs Neisseria appear in red (negative Gram) and in areas grouped in pairs (diplococci), within cells in the sample. the appearance of these Gram negative diplococci is sufficient for a presumptive diagnosis of gonorrhea.
The crops give absolute information of infection. Neisseria organisms can grow on any mucous membrane. The choice of site culture is determined depending on the person, sexual preference, and sexual practices. Generally, cultures are obtained from the urethra, anus, or throat. Laboratories can give a preliminary frequently within 24 hours and confirmed diagnosis within 72 hours.
Diagnosis and treatment
There are two aspects to be addressed in an STD, especially if it is as contagious as the gonorrhea. The first is to cure the affected person. The second is to locate all sexual contacts to try to prevent further spread of the disease.
During the war in Vietnam it was found that gonorrhea resistant to penicillin and tetracycline. This resistance has increased in recent years. Therefore they have designed new treatment regimens with several types of antibiotics of last generation, more powerful:
- Ceftriaxone, 125 mg intramuscularly once.
- Cefixime 400 mg orally once.
- Ciprofloxacin, 500 mg orally, once.
- Ofloxacin, 400 mg orally once.
- Spectinomycin, 2 g intramuscularly once.
- Cefuroxime Axotal, 1 g orally once.
- Cefpodoxime proxetil, 200 mg orally once.
- Enoxacin, 400 mg orally once.
- Erythromycin 500 mg orally four times a day for a week.
- It is important to make a follow-up visit 7 days after treatment and make new crops to confirm the cure of infection.
Prognosis and complications
When gonorrhea is treated immediately from the start, the result is good: there is no permanent scars on the urethra and spread of infection to other parts of the body.
Untreated gonorrhea can spread to other parts of the body, causing various complications:
- periurethral abscess.
- Gonococcal arthritis.
- gonococcal pharyngitis.
- gonococcal conjunctivitis.
- Infection or inflammation of the male reproductive system:
- vesiculitis seminal.
When seeing a doctor
If you have symptoms of gonorrhea should see your doctor immediately.
Inform the health authorities allows precise statistics on the number of cases and treat other infected contacts who can transmit the disease.
If you make risky sexual practices (multiple partners, unknown partners, high-risk partners, etc.) should be periodically tested for the possible presence of asymptomatic disease.