Gonorrhea

Lore & Background

Gonorrhea infections of mucosal membranes can cause swelling, itching, pain, and the formation of pus. The time from exposure to symptoms is usually between two and 14 days, with most symptoms appearing between four and six days after infection, if they appear at all. Infected males may experience pain or burning with urination, discharge from the penis, or testicular pain, while infected females may experience burning with urination, vaginal discharge, vaginal bleeding between periods, or pelvic pain. Many of those infected, however, have no symptoms. Half of women with gonorrhea are asymptomatic, and throat infections produce no symptoms in 90% of cases.

Reader's Guide

Gonorrhea is a major public health issue due to its high prevalence and potential for serious complications if untreated. In women, untreated gonorrhea can lead to pelvic inflammatory disease, which can cause scarring of the fallopian tubes and result in ectopic pregnancy or infertility. In men, it can cause inflammation of the epididymis, which may lead to infertility. The infection can also spread to joints, heart valves, or the spinal column, causing endocarditis or meningitis, particularly in immunocompromised individuals. Diagnosis is typically via PCR-based testing of urine, urethral, cervical, or vaginal swabs, or culture for certain samples. Treatment usually involves ceftriaxone by injection and azithromycin by mouth, though resistance to many antibiotics has developed. Prevention includes condom use, having sex with only one uninfected partner, and not having sex. Vaccines originally designed for meningococcus serotype B have shown some protective effect. The infection is especially risky for sexually active women under 25 and men who have sex with men.

Did You Know?

• Gonorrhea can be transmitted from a mother to her newborn during birth, causing ophthalmia neonatorum in 28% of untreated cases.
• Men have a 20% risk of infection from a single act of vaginal intercourse with an infected woman, while women have a 60–80% risk from an infected man.
• Previous infection with gonorrhea does not confer immunity; a person can be reinfected.
• Gonorrhea increases susceptibility to HIV infection and can make both diseases more transmissible.