Gonorrhea may also be spread by contact with infected bodily fluids, so that a mother could pass on the infection to her newborn during childbirth. Both men and women can get gonorrhea. The infection is easily spread and occurs most often in people who have many sex partners.
SINGS AND SYMPTOMS.
Gonorrhea symptoms in women -pain with intercourse
-Greenish yellow or whitish discharge from the vagina
-Lower abdominal or pelvic pain
-Burning when urinating
-Conjunctivitis (red, itchy eyes)
-Bleeding between periods
-Spotting after intercourse
-Swelling of the vulva (vulvitis)
-Burning in the throat (due to oral sex)
-Swollen glands in the throat (due to oral sex)
-In some women, symptoms are so mild that they escape unnoticed.
Many women with gonorrhea discharge think they have a yeast infection and self-treat with over-the-counter yeast infection drug. Because vaginal discharge can be a sign of a number of different problems, it is best to always seek the advice of a doctor to ensure proper diagnosis and treatment.
Gonorrhea symptoms in men
-Greenish yellow or whitish discharge from the penis
-Burning when urinating
-Burning in the throat (due to oral sex)
-Painful or swollen testicles
-Swollen glands in the throat (due to oral sex)
-In men, symptoms usually appear two to 14 days after infection.
The incubation period is 2 to 14 days with most of these symptoms occurring between 4–6 days after being infected.Rarely, gonorrhea may cause skin lesions and joint infection (pain and swelling in the joints) after traveling through the blood stream (see below). Very rarely it may settle in the heart causing endocarditis or in the spinal column causing meningitis (both are more likely among individuals with suppressed immune systems, however).
DIAGNOSIS
Traditionally, gonorrhea was diagnosed with gram stain and culture; however, newer polymerase chain reaction (PCR) based testing methods are becoming more common.In those who fail initial treatment culture should be done to determine sensitivity to antibiotics. All people who test positive for gonorrhea should be tested for other sexually transmitted diseases such as chlamydia, syphilis and human immunodeficiency virus.
SCREENING
The United States Preventive Services Task Force recommends screening for gonorrhea in women at increased risk of infection which includes all sexually active women younger than 25 years. It is not recommended in males without symptoms or low risk women.
Screening for gonorrhea in women who are (or intend to become) pregnant, and who are found to be at high risk for sexually transmitted diseases, is recommended as part of prenatal care in the most countries.
CAUSES
Gonorrhea is caused by the bacterium Neisseria gonorrhoeae.
The infection is transmitted from one person to another through vaginal, oral, or anal sex.
Men have a 20% risk of getting the infection from a single act of vaginal intercourse with an infected woman. The risk for men who have sex with men is higher.
Women have a 60–80% risk of getting the infection from a single act of vaginal intercourse with an infected man.
A mother may transmit gonorrhea to her newborn during childbirth; when affecting the infant's eyes, it is referred to as ophthalmia neonatorum.It cannot be spread by toilets or bathrooms.
TREATMENT
Antibiotics that may be used to treat gonorrhea include:
•Amoxicillin 2 g plus probenecid 1 g orally
•Ampicillin 2 to 3 g plus probenecid 1 g orally
•Azithromycin 2 g orally
•Cefixime 400 mg orally
•Cefotaxime 500 mg by intramuscular injection
•Cefoxitin 2 g by intramuscular injection, plus probenecid 1 g orally
•Cefpodoxime (Vantin) 400 mg orally
•Ceftriaxone (Rocephin) 125 to 250 mg by intramuscular injection
•Ciprofloxacin 500 mg orally
•Levofloxacin 250 mg orally
•Ofloxacin 400 mg orally
•Spectinomycin 2 g by intramuscular injection
The level of tetracycline resistance in ''Neisseria gonorrhœae'' is now so high as to make it completely ineffective in most parts of the world.
The fluoroquinolones (ciprofloxacin, ofloxacin, levofloxacin) cannot be used in pregnancy. It is important to refer all sexual partners to be checked for gonorrhea to prevent spread of the disease and to prevent the patient from becoming re-infected with gonorrhea.
Patients should also be offered screening for other sexually transmitted infections. In areas where co-infection with chlamydia is common, doctors may prescribe a combination of antibiotics, such as ceftriaxone with doxycycline or azithromycin, to treat both diseases.
Penicillin is ineffective at treating rectal gonorrhea because other bacteria within the rectum produce β-lactamases that destroy penicillin.
All current treatments are less effective at treating gonorrhea of the throat, so the patient must be rechecked by throat swab 72 hours or more after being given treatment, and then retreated if the throat swab is still positive.
Although gonorrhea usually does not require follow-up (with the exception of rectal or pharyngeal disease), patients are usually advised to phone for results five to seven days after diagnosis to confirm that the antibiotic they received was likely to be effective.
Patients are advised to abstain from sex during this time.
Drug-resistant strains are known to exist.
PartnersIt is recommended that sexual partners be tested and potentially treated.One option for treating sexual partners of people infected is patient-delivered partner therapy (PDPT) which involves providing prescriptions or medications to the person to take to their partner without the health care provider first examining them.
Why ANTIBIOTICS Is Used;
antibiotics are used to treat:
-A person who has a positive gonorrhea test.
-Sex partners within the past 60 days of a person diagnosed with gonorrhea, whether or not they have symptoms or used condoms.
-A newborn whose mother has gonorrhea at the time of delivery.
PREVENTION
To reduce your risk of gonorrhea infection:
-Use condoms correctly every time you have sex.
-Limit the number of sex partners, and do not go back and forth between partners.
-Practice sexual abstinence, or limit sexual contact to one uninfected partner.
-If you think you are infected, avoid sexual contact and see a doctor.
-Any genital symptoms such as discharge or burning during urination or an unusual sore or rash should -be a signal to stop having sex and to consult a doctor immediately. If you are told you have gonorrhea or any other STD and receive treatment, you should notify all of your recent sex partners so that they can see a doctor and be treated.
COMPLICATIONS
Untreated gonorrhea can cause serious and permanent problems in both women and men.
In women,
if left untreated, the infection can cause pelvic inflammatory disease, which may damage the fallopian tubes (the tubes connecting the ovaries to the uterus) or even lead to infertility, and untreated gonorrhea infection could increase the risk of ectopic pregnancy (when the fertilized egg implants and develops outside the uterus), a dangerous condition for both the mother and baby.
Gonorrhea can spread to the blood or joints. This condition can be life-threatening.
Also, people with gonorrhea can more easily contract HIV, the virus that causes AIDS. People with HIV infection and gonorrhea are more likely than people with HIV infection alone to transmit HIV to someone else
In men,
inflammation of the epididymis (epididymitis); prostate gland (prostatitis) and urethral stricture (urethritis) can result from untreated gonorrhea.[21] In women, the most common result of untreated gonorrhea is pelvic inflammatory disease. Other complications include perihepatitis,[21] a rare complication associated with Fitz-Hugh-Curtis syndrome; septic arthritis in the fingers, wrists, toes, and ankles; septic abortion; chorioamnionitis during pregnancy; neonatal or adult blindness from conjunctivitis; and infertility.
Neonates coming through the birth canal are given erythromycin ointment in the eyes to prevent blindness from infection.
The underlying gonorrhea should be treated; if this is done then usually a good prognosis will follow.
