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Gonorrhea
What is Gonorrhea?
Gonorrhea is a curable sexually transmitted infection (STI) caused
by a bacterium called Neisseria gonorrhoeae. These bacteria can
infect the genital tract, the mouth, and the rectum. In women, the
opening of the uterus, the cervix, is the first place of infection.
The infection however
can spread into the uterus and fallopian tubes, resulting in pelvic
inflammatory disease (PID). PID affects more than 1 million women in
the United States every year and can cause infertility in as many as
10% of infected women and tubal (ectopic) pregnancy.
In 2000, 358,995
cases of gonorrhea were reported to the U.S. Center for Disease
Control and Prevention (CDC). In the United States, approximately
75% of all reported cases of gonorrhea are found in younger person
aged 15 to 29 years. The highest rates of infection are usually
found in 15 to 19-year old women and 20 to 24-year old men. Health
economists estimate that the annual cost of gonorrhea and its
complications is close to $1.1 billion.
Gonorrhea is spread
during sexual intercourse. Infected women can pass gonorrhea to
their newborn infants during delivery, causing eye infections in
their babies. This complication is rare because newborn babies
receive eye medicine to prevent infection. When the infection occurs
in the genital tract, mouth, or rectum of a child, it is due most
commonly to sexual abuse.
What Are the
Symptoms of Gonorrhea?
The early symptoms of gonorrhea often are mild. Symptoms usually
appear within 2 to 10 days after sexual contact with an infected
partner. A small number of people may be infected for several months
without showing symptoms.
When women have
symptoms, the first ones may include:
- Bleeding associated with vaginal intercourse
- Painful or burning sensations with urinating
- Vaginal discharge that is yellow or bloody
More advanced
symptoms, which may indicate development of PID, include cramps and
pain, bleeding between menstrual periods, vomiting, or fever.
Men have symptoms
more often than women, including:
- Pus from the penis and pain
- Burning sensations during urination that may be severe
Symptoms of rectal
infection include discharge, anal itching, and occasional painful
bowel movements with fresh blood on the feces.
How is Gonorrhea
Diagnosed?
Doctors or other health care workers usually use three laboratory
techniques to diagnose gonorrhea; staining samples directly for the
bacterium, detection of bacterial genes or DNA in urine, and growing
the bacteria in laboratory cultures. Many doctors prefer to use more
than one test to increase the change of an accurate diagnosis.
The staining test
involves placing a smear of the discharge from the penis or the
cervix on a slide and staining the smear with a dye. The the doctor
uses a microscope to look for bacteria on the slide. You can usually
get the test results while in the office or clinic. This test is
quite accurate for men but it not good in women. Only one in two
women with gonorrhea have a positive stain.
More often, doctors
use urine or cervical swabs for a new test that detects the genes of
the bacteria. These tests are as accurate or more so than culturing
the bacteria, and many doctors use them.
The culture test
involves placing a sample of the discharge onto a culture plate and
incubating it up to 2 days to allow the bacteria to grow. The
sensitivity of this test depends on the site from which the sample
is taken. Cultures of cervical samples detect infection
approximately 90% of the time. The doctor also can take a culture to
detect gonorrhea in the throat. Culture allows testing for durg-resistant
bacteria.
How is Gonorrhea
Treated?
Doctors usually prescribe a single dose of one of the following
antibiotics to treat gonorrhea:
- Cefixime
- Ceftriaxone
- Ciprofloxacin
- Ofloxacin
- Levofloxacin
If you have gonorrhea
and are pregnant or younger than 18 years old, you should not take
ciprofloxacin or ofloxacin. Your doctor can prescribe the best and
safest antibiotic for you.
Gonorrhea and
chlamydial infection, another common STI, often infect people at the
same time. Therefore, doctors usually prescribe a combination of
antibiotics, such as ceftriaxone and doxycycline or azithromycin,
which will treat both infections.
If you have
gonorrhea, all of your sexual partners should get tested and then
treated if infected, whether or not they have symptoms of infection.
What Can Happen if
Gonorrhea is Not Treated?
In untreated gonorrhea infections, the bacteria can spread up into
the reproductive tract, or more rarely, can spread through the blood
stream and infect the joints, heart valves, or the brain.
The most common
result of untreated gonorrhea is PID, a serious infection of the
female reproductive tract. Gonococcal PID often appears immediately
after the menstrual period. PID causes scar tissue to form in the
fallopian tubes. If the tube is partially scarred, the fertilized
egg may not be able to pass into the uterus. If this happens, the
embryo may implant in the tube causing tubal (ectopic) pregnancy.
This serious complication may result in miscarriage and can cause
death of the mother.
Rarely, untreated
gonorrhea can spread through the blood to the joints. This can cause
an inflammation of the joints which is very serious.
If you are infected
with gonorrhea, your risk of getting HIV infection increases.
Therefore, it is extremely important for you to either prevent
yourself from getting gonorrhea or get treated early if you already
are infected with it.
Can Gonorrhea
Affect a Newborn Baby?
If you are pregnancy and have gonorrhea, you may give the infection
to you baby as it passed through the birth canal during delivery. A
doctor can prevent infection of your baby's eyes by applying silver
nitrate or other medications to the eyes immediately after birth.
Because of the risks from gonoccocal infection to both you and your
baby, doctors recommend that pregnant women have at least one test
for gonorrhea during pregnancy.
Note: All information
is based upon materials published by the National Institute of
Allergy and Infectious Diseases (NIAD).
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