Gonorrhea Fall '10

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Gonorrhea


Gonorrhea is a sexually transmitted disease or infection that is caused by the bacterium Neisseria gonorrhoeae. It can be spread by sexual contact, either through vaginal intercourse, oral and/or anal sex with an infected partner. It can infect, grow and multiply in warm, moist areas of the reproductive tract, which includes the cervix, uterus and fallopian tubes in women, and the urethra in men and women. It can also grow in the anus. A woman who has gonorrhea while she is pregnant may pass the infection to the baby through the birth canal [5].

It can be diagnosed by performing several laboratory tests and taking samples from the parts of the body that might be infected, such as the cervix, urethra, etc. Also, a Gram stain can be used to observe the gonorrhea bacterium under a microscope.

There are many different treatment options to help cure gonorrhea at an early stage. The best way to prevent gonorrhea or any transmission of STDs is to practice abstinence or stay in a monogamous long-term relationship with one partner that is uninfected. Latex condoms can be used during sexual intercourse to lower the chances of gonorrhea transmission [4].

Organism


Neisseria gonorrhoeae.jpg

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. It is a Gram-negative pathogenic bacteria that colonizes and invades the mucosal surface of the epithelium layer of the genitals. The bacteria multiplies on the basement membrane and causes inflammation and abnormal discharge. The shape is coccus, it is a mesophilic organism and its optimal temperature is between 35-37 degrees Celsius [8].

Scientific name


Neisseria gonorrhoeae is the scientific name of the bacterium that causes gonorrhea. It is also known as gonococci (gonococcus: singular). A common slang word for gonorrhea is "the clap".

Gonorrhea clap.jpg

Symptoms


For women,

  • Dysuria (painful urination)
  • Genital Itching
  • Fever
  • Painful sexual intercourse (even bleeding)
  • Abnormal vaginal discharge
  • Abdominal cramps
  • Irregular menstrual periods
  • Vomiting
  • Possible sore throat
  • Possible conjunctivitis (pinkeye)
Gonoeye.jpg

For men,

  • Dysuria
  • Abnormal discharge from the penis
  • Swollen or painful testicles
  • Possible sore throat
  • Possible conjunctivitis (pinkeye) [12]

Gonorrhea passage.png

Statistics


Gonorrhea stat.gif

According to the CDC, in 2009, young adults and adolescents had the highest rates of gonorrhea compared to other age groups. For women, ages 15-19 and 20-24 had the highest rates, while for men, ages 20-24 had the highest [7].

Gonorrhea region stat.gif

According to the CDC, in 2009, the Southern region recorded the highest rate of gonorrhea compared to the other three regions of the United States [7].

Gonorrhea stat by race.gif

According to the CDC, in 2009, the African-American population had the highest gonorrhea rates, compared to Caucasians and other non-Caucasian people [7].

Treatment


There are many different options for treating gonorrhea. Some include:

  • Cefixime 400 mg orally, single dose
  • Ceftriaxone 125 mg IM, single dose
  • Ciprofloxacin 500 mg orally, single dose
  • Single-dose cephalosporin regimens
  • Ofloxacin 400 mg orally, single dose + Azithromycin 1 g orally, single dose
  • Doxycycline 100 mg orally twice a day for 7 days [11]


If the gonorrhea infection isn't treated, it can cause problems within the body by spreading by passage of the bloodstream. It can spread to the joints of the body as well.


If left untreated in women, it can cause:

  • Chronic pelvic pain
  • Pelvic inflammatory disease (PID)
  • Damage to fallopian tubes
  • Increased risk of ectopic pregnancy

If left untreated in men, it can cause:

  • Epididymitis (inflammation of the epididymis)
  • Prostate complications

If infection is passed from the woman to baby, they can develop:

  • Blindness
  • Joint infection
  • Blood infection (possibly life-threatening) [5]
Gonorrhea infant.JPG

For both men and women, if the infection spreads and causes enough damage, it may lead to infertility.

Related Diseases/Sequelae


Neisseria gonorrhoeae is closely related to Chlamydia trachomatis, which is the bacterium that causes chlamydia in people. Both bacteria are Gram-negative and cause relatively the same symptoms, such as PID, ectopic pregnancy and infertility in women and testicular pain and inflammation in men. Both can be treated with similar antibiotics, such as azithromycin and doxycycline [10].

Chlamydia is the most common STD in the US, while the second most common is gonorrhea [1].

References

1. Datta, S. Deblina, and Maya Steinberg. "Gonorrhea and Chlamydia in the United States among Persons 14 to 39 Years of Age, 1999 to 2002 — Ann Intern Med." Annals of Internal Medicine. 17 July 2007. Web. 30 Oct. 2010. <http://www.annals.org/content/147/2/89.full>.

2. Forhan, Sara E., and Sami L. Gottlieb. "Prevalence of Sexually Transmitted Infections Among Female Adolescents Aged 14 to 19 in the United States -- Forhan Et Al. 124 (6): 1505 -- Pediatrics." Pediatrics | Official Journal of the American Academy of Pediatrics. 23 Nov. 2009. Web. 30 Oct. 2010. <http://pediatrics.aappublications.org/cgi/content/full/124/6/1505>.

3. Newman, Lori M., John S. Moran, and Kimberly A. Workowski. "Update on the Management of Gonorrhea in Adults in the United States." Clinical Infectious Diseases 44.S3 (2007): S84-101. Print.

4. "STD Facts - Gonorrhea." Centers for Disease Control and Prevention. Web. 30 Oct. 2010. <http://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm>.

5. "Gonorrhea." National Institute of Allergy and Infectious Diseases Home Page. Web. 30 Oct. 2010. <http://www.niaid.nih.gov/topics/gonorrhea/pages/default.aspx>.

6. Girardet, Rebecca G., Laurie A. Howard, and Sheela Lahoti. "Epidemiology of Sexually Transmitted Infections in Suspected Child Victims of Sexual Assault -- Girardet Et Al. 124 (1): 79 -- Pediatrics." Pediatrics | Official Journal of the American Academy of Pediatrics. 29 June 2009. Web. 30 Oct. 2010. <http://pediatrics.aappublications.org/cgi/content/full/124/1/79>.

7. "CDC - STD Surveillance, 2009 - Gonorrhea." Centers for Disease Control and Prevention. Web. 24 Nov. 2010. <http://www.cdc.gov/std/stats09/gonorrhea.htm>.

8. "Pathogenic Neisseriae: Gonorrhea and Meningitis." Online Textbook of Bacteriology. Web. 25 Nov. 2010. <http://www.textbookofbacteriology.net/neisseria.html>.

9. "Gonorrhea Symptoms, Pictures, Treatment | STD Gonorrhea." STD Symptoms Pictures Treatment | STDs Information. Web. 25 Nov. 2010. <http://www.std-gov.org/stds/gonorrhea.htm>

10. "Chlamydia and Gonorrhea - McKinley Health Center - University of Illinois." McKinley Health Center - University of Illinois at Urbana-Champaign. Web. 25 Nov. 2010. <http://www.mckinley.illinois.edu/handouts/chlamydia_gonorrhea.html>.

11. Cornforth, By Tracee. "Gonorrhea - Symptoms - Treatments - Prevention." Women's Health Issues - Women's Health Questions and Answers - Women's Sexual Health. Web. 25 Nov. 2010. <http://womenshealth.about.com/cs/gonorrhea1/a/gonorrheasytrtm.htm>.

12. "Gonorrhea-Topic Overview." WebMD - Better Information. Better Health. Web. 25 Nov. 2010. <http://www.webmd.com/sexual-conditions/tc/gonorrhea-topic-overview>.

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