Gonorrhoea

Gonorrhoea

• Neisseria gonorrhoea

• Gram negative diplococcus

• STI

Presentation Of Gonorrhoea

• Odourless purulent discharge, possibly green or yellow

• Dysuria

• Pelvic pain/testicular pain (epididymo-orchitis)

Signs Of Gonorrhoea

• Rectal infection→ usually asymptomatic

• Pharyngeal infection→ sore throat

• Prostatitis→ perineal pain, tender

• Conjuctivitis→ erythema and purulent discharge

Investigation For Gonorrhoea

• NAAT to test for gonococcal RNA/DNA

• Charcoal endocervical swab to determine which antibiotic to use

Management Of Gonorrhoea

• A single dose of intramuscular ceftriaxone 1g if the sensitivities are NOT known

• A single dose of oral ciprofloxacin 500mg if the sensitivities ARE known

Gonorrhoea Test Of Cure

All patients should have a follow-up “test of cure” given the high antibiotic resistance:

• 72 hours after treatment for culture

• 7 days after treatment for RNA NAAT

• 14 days after treatment for DNA NAAT

Neonatal Conjuctivitis

“Opthalmia neonatorum”→ medical emergency associated with sepsis, perforation of the eye and blindness

Disseminated Gonococcal Infection

Disseminated gonococcal infection (GDI) is a complication of untreated gonococcal infection, where the bacteria spreads to the skin and joints. It causes:

• Various non-specific skin lesions

• Polyarthralgia (joint aches and pains)

• Migratory polyarthritis (arthritis that moves between joints)

• Tenosynovitis

• Systemic symptoms such as fever and fatigue