Doctor's Notes on Gonorrhea
Gonorrhea is a common sexually transmitted infection caused by the Neisseria gonorrhoeae bacteria. Gonorrhea infection is transmitted from one person to another through vaginal, oral, or anal sexual contact. In addition, an infected mother may transmit gonorrhea to her newborn during vaginal childbirth.
Symptoms of gonorrhea infection may be different in women and men. Many women will have no symptoms. When symptoms of gonorrhea do appear in women, they may include
- pelvic inflammatory disease (PID),
- infection and irritation of the cervix,
- frequent need to urinate,
- vaginal itching and burning,
- a thick yellow/green discharge,
- vaginal infection, and
- bleeding between menstrual periods.
Symptoms of gonorrhea in men may include
- pain or burning during urination,
- thick and yellow penile discharge,
- inflammation and tenderness of a duct in the testicles, and
- inflammation and pain in the prostate gland.
In newborns, symptoms of gonorrhea include
- irritation of the mucous membranes in the eyes.
- Symptoms of oral and rectal gonorrhea may include sore throat or rectal pain or discharge.
What Is the Treatment for Gonorrhea?
Treatment for gonorrhea involves a one-time dose of an antibiotic called ceftriaxone injected into the muscle.
Because of increasing resistance of many tested samples of N. gonorrhoeae to the fluoroquinolone antibiotics, the Centers for Disease Control (CDC) now recommends that only one class of antibiotics, the cephalosporins, be used to treat gonorrheal infections.
If there is an allergy to ceftriaxone, alternate possible treatments may include:
- Gentamicin 240 mg IM in a single dose
- Azithromycin 2 g orally in a single dose
- Cefixime 800 mg orally in a single dose
Sexual partners should also receive treatment for gonorrhea because re-infection is common, and patients should be retested for gonorrhea three months after treatment of the initial infection. Unprotected sex should be avoided until both the patient and partner have been treated.
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Pelvic Inflammatory Disease (PID)Pelvic inflammatory disease (PID), an infection of a woman's reproductive organs (cervicitis, salpingitis, endometritis, and peritonitis) is an STD caused by either the Chlamydia trachomatis or Neisseria gonorrhoeae bacteria. Symptoms of PID include abdominal pain, abnormal vaginal bleeding, heavy vaginal discharge, painful urination, or painful intercourse. Treatment is generally with antibiotics or surgery.
ProctitisProctitis is an inflammation of the anus rectal lining. Symptoms include pain, bleeding, spasms during bowel movements, a feeling of being unable to empty the bowels completely. Treatment includes safe sex practices and antibiotics.
Sexually Transmitted Diseases (STDs)Sexually transmitted diseases (STDs) are among the most common infectious diseases in the United States. STDs can be spread through any type of sexual activity involving the sex organs, the anus or mouth, or through contact with blood during sexual activity. Examples of STDs include, chancroid, chlamydia, gonorrhea, granuloma inguinale, lymphogranuloma venereum, syphilis, genital herpes, genital warts, hepatitis B, trichomoniasis, pubic lice (crabs), and scabies.Treatment is generally with antibiotics; however, some STDs that go untreated can lead to death.
Urethritis in MenUrethritis, inflammation of the urethra, may cause symptoms and signs that include discharge, burning, pain, urinary urgency, itching, and blood in the urine. Treatment involves antibiotics, sitz baths, drinking plenty of fluids, and taking nonsteroidal anti-inflammatory medications.
Vaginal InfectionsVaginal infections, or vaginitis, describe the most common medical concerns women have in the area of their reproductive organs. Vaginitis is an inflammation of the vagina that creates discharge, odor, and other symptoms.
What Is Usually the First Sign of Gonorrhea?Pain or burning during urination is usually the first sign of gonorrhea, a bacterial infection transmitted sexually.
Why Is Gonorrhea Called the Clap?Gonorrhea is a bacterial sexually transmitted disease (STD) that is sometimes called "the clap." The origin of this nickname is not known, but it can be traced to several words with various meanings, including the French word "clapier" (brothel), the old English word "clappan" (to beat or throb), and others.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.