vague, such as lower abdominal discomfort, and
go away in a few days to a week. When symptoms
are present they typically include
- a thick, discolored (yellowish or greenish), or
bloody discharge from the PENISin men and the
VAGINAin women - burning or PAINwith URINATION(more common
in men) - pain or bleeding during SEXUAL INTERCOURSE
(more common in women)
Early symptoms will go away without treat-
ment, though the infection remains. As the N. gon-
orrhoeaeBACTERIAmultiply in the body, they cause
increasing irritation to the tissues, resulting in
INFLAMMATIONand the formation of SCARtissue. In
men the next level of infection with untreated
gonorrhea is EPIDIDYMITIS, which causes swelling
and pain in the TESTICLES, and URETHRITIS, which
causes intense pain with urination. In women the
next level of infection with untreated gonorrhea is
PELVIC INFLAMMATORY DISEASE(PID), which involves
the UTERUSand FALLOPIAN TUBES. PID often causes
severe ABDOMINAL PAIN. Scarring from the infection
blocks the fallopian tubes, putting a woman at
high risk for ECTOPIC PREGNANCY.
Diagnosis is laboratory examination of a sample
of the discharge taken from the penis (men) or the
CERVIX(women). A fast test done in the doctor’s
office is highly accurate for men but not for
women; for women, a conventional culture is the
most reliable diagnostic procedure. The doctor
likely will conduct diagnostic tests for other STDs
as well, notably CHLAMYDIAand SYPHILIS. All sex
partners should also undergo testing and receive
treatment if they have gonorrhea, even if they do
not have symptoms.
Treatment Options and OutlookThe current standard of treatment for gonorrhea is
a single DOSE of a fluoroquinolone antibiotic,
which cures the infection in most people. How-
ever, new strains of N. gonorrhoeaeare showing
resistance to these antibiotics, causing doctors to
look to combinations of antibiotics and to stronger
antibiotics to cure the infection.ANTIBIOTIC MEDICATIONS TO TREAT GONORRHEA
azithromycin cefixime
ceftriaxone ciprofloxacin
levofloxacin ofloxacinThe debut of penicillin in the 1940s provided
the first cure for gonorrhea. However, 30 years
later, most strains of N. gonorrhoeaewere resistant
to penicillin and to tetracycline, the second-choice
antibiotic. Doctors can no longer prescribe these
antibiotics to treat gonorrhea. Though antibiotic
medications remain the standard of treatment for
gonorrhea, doctors and public health officials
worry that the ability of N. gonorrhoeaeto adapt
will soon put gonorrhea out of reach for treat-
ment. Researchers have recently unraveled the
GENETIC CODE(DNAsequence) of theN. gonorrhoeae
and are hopeful this advance will lead to new
kinds of treatments.Risk Factors and Preventive Measures
Those who are at highest risk for gonorrhea and
other STDs are- women between the ages of 15 and 19
- men between the ages of 20 and 24
- men who have sex with men
- men or women who have multiple sex partners
Monogamy (having only one sex partner) and
consistent use of latex condoms are measures that
can prevent N. gonorrhoeaeinfection. People who
are sexually active should undergo regular testing
for STDs. Reinfection can occur.
See also ANTIBIOTIC RESISTANCE; GENITAL HERPES;
HIV/AIDS; HUMAN PAPILLOMAVIRUS (HPV); SEXUAL
HEALTH; SEXUALLY TRANSMITTED DISEASE(STD) PREVEN-
TION; SEXUALLY TRANSMITTED DISEASES(STDS).330 Infectious Diseases