Gonorrhea is a sexually transmitted disease which is caused by the bacterial organism Neisseria gonorrhea. It is easy treatable but can cause a lot of complications especially in women if left untreated. It is one of the most common causes of sexually transmitted diseases worldwide.

Gonorrhea can be transmitted through oral, anal and vaginal sex. Gonorrhea can also be transmitted from an infected mother to a new born baby.

Gonorrhea affects about 0.8% of women and 0.6% of men.  An estimated 78 million (53–110 million)  new cases of gonorrhea was recorded in the year 2015. In this same year, it caused about 700 deaths.

 

Symptoms

Gonorrhea is usually asymptomatic in 50% of women.  The symptoms can however appear from 1-14 days after infection. The general symptoms they manifest with include;

  • Abnormal penile discharge which can be white, yellow or green
  • Pain during urination
  • Frequent urination
  • Painful scrotum
  • Anal discharge, itching, pain, bleeding, or pain when passing stools
  • Greenish or yellowish vaginal discharge
  • Painful sexual intercourse
  • Irregular menstrual bleeding
  • Fever
  • Abdomino-pelvic pain
  • Painful and frequent urination
  • Red, painful and swollen joint
  • Itching, difficulty swallowing, or swollen neck lymph node
  • In babies, they present with purulent and copious eye discharge few days after delivery.

Diagnosis

Penile discharge can be taken for  gram staining and culture to confirm the presence of the organism.  A high vaginal swb and endo cervical swab can be taken to confirm the disease in women. It is also important to rule out other sexually transmitted disease in a person with gonorrhea.

Treatment

Gonorrhea is curable. Antibiotics such as injectable ceftriaxone with doxycycline/azithromycin is ideal in treating the infection. The incidence of antibiotics resistance has been on the rise, it is therefore important the appropriate medication is properly taken to avoid drug resistance.

It is important to treat the partners of whoever has the infection so as to avoid reinfection.

It is important to treat gonorrhea in pregnant women so they don’t spread the disease to the child during delivery.

 

Complication

  • It increases the risk of having HIV.
  • Infertility; if untreated especially in women it leads to damage of the fallopian tubes which will prevent fertilization of the ovary by the sperm. Also, the transport of embryo to the uterus for implantation is affected.
  • It can cause blindness in babies if it is not properly and promptly treated.
  • Pelvic inflammatory disease; inflammation of the female genital tract, accompanied by fever and lower abdominal pain.
  • Inflammation of the epididymis (a highly convoluted duct behind the testis, along which sperm passes to the vas deferens).
  • Meningitis; inflammation of the meninges of the brain.
  • Endocarditis; inflammation of the inner linning of the heart (endocardium)
  • Men who have had a gonorrhea infection have an increased risk  of getting prostate cancer.

 

Prevention

It is important to use protection (condoms) during sexual intercourse as it reduces the chances of having the infection.

Prompt treatment of pregnant women with gonorrhea is very iumportant.

Previous infection doesn’t confer immunity against the disease it is therefore important to always avoid infection.