Gonorrhea
A common sexually transmitted disease, gonorrhea is an infection of the genitourinary tract (especially the urethra and cervix) and, occasionally, the rectum, pharynx, and eyes. Untreated gonorrhea can spread through the blood to the joints, tendons, meninges, and endocardium; in females, it can also lead to chronic pelvic inflammatory disease (PID) and sterility.
After adequate treatment, the prognosis in both males and females is excellent, although reinfection is common. Gonorrhea is especially prevalent among young people and people with multiple partners, particularly those between ages 19 and 25.
Causes
Transmission of Neisseria gonorrhoeae, the organism that causes gonorrhea, almost exclusively follows sexual contact with an infected person. Children born of infected mothers can contract gonococcal ophthalmia neonatorum during passage through the birth canal. Children and adults with gonorrhea can contract gonococcal conjunctivitis by touching their eyes with contaminated hands.
Signs and symptoms
Although many infected males are asymptomatic, after a 3- to 6-day incubation period, some develop symptoms of urethritis, including dysuria and purulent urethral discharge, with redness and swelling at the site of infection. Most infected females remain asymptomatic but may develop inflammation and a greenish yellow discharge from the cervix—the most common gonorrheal symptoms in females.
Other clinical features vary according to the site involved:
urethra— dysuria, urinary frequency and incontinence, purulent discharge, itching, red and edematous meatus
vulva— occasional itching, burning, and pain due to exudate from an adjacent infected area (vulval symptoms are more severe before puberty and after menopause)
vagina (most common site in children over age 1)—engorgement, redness, swelling, and profuse purulent discharge
pelvis— severe pelvic and lower abdominal pain, muscle rigidity, tenderness, and abdominal distention (as the infection spreads, nausea, vomiting, fever, and tachycardia may develop in patients with salpingitis or PID)
liver— right-upper-quadrant pain in patients with perihepatitis.
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