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Gonorrhea

Clap; The drip

Gonorrhea is a common sexually transmitted infection (STI).

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Causes

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. Any type of sex can spread gonorrhea. You can get it through contact with the mouth, throat, eyes, urethra, vagina, penis, or anus.

Gonorrhea is the second most commonly reported communicable disease. Approximately 330,000 cases occur in the US each year.

The bacteria grow in warm, moist areas of the body. This can include the tube that carries urine out of the body (urethra). In women, the bacteria may be found in the reproductive tract (which includes the fallopian tubes, uterus, and cervix). The bacteria can also grow in the eyes.

Health care providers are required by law to tell the State Board of Health about all cases of gonorrhea. The goal of this law is make sure the person gets proper follow-up care and treatment. Sexual partners also need to be found and tested.

You are more likely to develop this infection if:

Symptoms

Symptoms of gonorrhea most often appear 2 to 5 days after infection. However, it may take up to a month for symptoms to appear in men.

Some people do not have symptoms. They may not know that they have caught the infection, so do not seek treatment. This increases the risk of complications and the chances of passing the infection on to another person.

Symptoms in men include:

Symptoms in women can be very mild. They can be mistaken for another type of infection. They include:

If the infection spreads to the bloodstream, symptoms include:

Exams and Tests

Gonorrhea can be quickly detected by looking at a sample of discharge or tissue under the microscope. This is called a gram stain. This method is fast, but it is not the most certain.

Gonorrhea is most accurately detected with DNA tests. DNA tests are useful for screening. The ligase chain reaction (LCR) test is one of the tests. DNA tests are quicker than cultures. These tests can be performed on urine samples, which are easier to collect than samples from the genital area.

Prior to DNA tests, cultures (cells that grow in a lab dish) were used to provide proof of gonorrhea, but are less commonly used now.

Samples for a culture are most often taken from the cervix, vagina, urethra, anus, or throat. Rarely, samples are taken from joint fluid or blood. Cultures can often provide an early diagnosis within 24 hours. A confirmed diagnosis is available within 72 hours.

If you have gonorrhea, you should ask to be tested for other sexually transmitted infections, including chlamydia, syphilis, and HIV herpes and hepatitis.

Treatment

A number of different antibiotics may be used for treating this type of infection.

About half of the women with gonorrhea are also infected with chlamydia. Chlamydia is treated at the same time as a gonorrhea infection.

You will need a follow-up visit 7 days after if your symptoms include joint pain, skin rash, or more severe pelvic or abdomen pain. Tests will be done to make sure the infection is gone.

Sexual partners must be tested and treated to prevent passing the infection back and forth. You and your partner must finish all of the antibiotics. Use condoms until you both have finished taking your antibiotics.

All sexual contacts of the person with gonorrhea should be contacted and tested. This helps prevent further spread of the infection.

Outlook (Prognosis)

A gonorrhea infection that has not spread can almost always be cured with antibiotics. Gonorrhea that has spread is a more serious infection. Most of the time, it gets better with treatment.

Possible Complications

Complications in women may include:

Complications in men may include:

Complications in both men and women may include:

When to Contact a Medical Professional

Call your health care provider right away if you have symptoms of gonorrhea. Most state-sponsored clinics will diagnose and treat STIs without charge.

Prevention

Avoiding sexual contact is the only sure way to prevent gonorrhea. If you and your partner do not have sex with any other people, this can greatly reduce your chance also.

Safe sex means taking steps before and during sex that can prevent you from getting an infection, or from giving one to your partner. Safe sex practices include screening for STIs in all sexual partners, using condoms consistently, having fewer sexual contacts.

Ask your provider if you should receive the hepatitis B vaccine-link and the HPV vaccine-link. You may also want to consider the HPV vaccine.

Related Information

Endocarditis
Meningitis

References

Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2013. US Department of Health and Human Services; 2014. www.cdc.gov/std/stats13. Updated March 30, 2015. Accessed July 15, 2015.

Embree JE. Gonococcal infections. In: Wilson CB, Nizet V, Maldonado YA, Remington JS, eds. Remington and Klein's Infectious Diseases of the Fetus and Newborn Infant. 8th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 15.

Final Recommendation Statement: Chlamydia and Gonorrhea: Screening. US Preventive Services Task Force.  www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/chlamydia-and-gonorrhea-screening. December 2014. Accessed July 15, 2015.

Habif TP. Sexually transmitted bacterial infections. In: Habif TP, ed. Clinical Dermatology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 10.

Marrazzo JM, Apicell MA. Neisseria gonorrhoeae (Gonorrhea). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 214.

Workowski KA, Bolan GA; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(3):1-137. PMID: 26042815 www.ncbi.nlm.nih.gov/pubmed/26042815.

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Review Date: 5/10/2017  

Reviewed By: Anita Sit, MD, Department of OB/GYN, Santa Clara Valley Medical Center, San Jose, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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