Gonorrhea physical examination: Difference between revisions
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==Physical examination== | ==Physical examination== | ||
The most common site of gonococcal infection is the urethra, endocervix, rectum, and pharynx. | |||
Physical examination of patients with gonococcal infection is usually remarkable for: | Physical examination of patients with gonococcal infection is usually remarkable for: | ||
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! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Physical Examination}} | ! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Physical Examination}} | ||
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| style="padding: 5px 5px; background: #DCDCDC;" | ''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Urogenital infection in men'''<ref name="pmid9038638">{{cite journal| author=Sherrard J, Barlow D| title=Gonorrhoea in men: clinical and diagnostic aspects. | journal=Genitourin Med | year= 1996 | volume= 72 | issue= 6 | pages= 422-6 | pmid=9038638 | doi= | pmc=1195730 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9038638 }} </ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Mucopurulent dishareg|Mucopurulent]] urethral discharge | * [[Mucopurulent dishareg|Mucopurulent]] urethral discharge | ||
| Line 21: | Line 22: | ||
* Periurethral abscesses | * Periurethral abscesses | ||
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| style="padding: 5px 5px; background: #DCDCDC;" | ''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Urogenital infection in women''':<ref name="pmid26042815">{{cite journal| author=Workowski KA, Bolan GA, Centers for Disease Control and Prevention| title=Sexually transmitted diseases treatment guidelines, 2015. | journal=MMWR Recomm Rep | year= 2015 | volume= 64 | issue= RR-03 | pages= 1-137 | pmid=26042815 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26042815 }} </ref><ref name="pmid76760">{{cite journal| author=Barlow D, Phillips I| title=Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects. | journal=Lancet | year= 1978 | volume= 1 | issue= 8067 | pages= 761-4 | pmid=76760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=76760 }} </ref><ref name="pmid17448399">{{cite journal| author=Huppert JS, Biro F, Lan D, Mortensen JE, Reed J, Slap GB| title=Urinary symptoms in adolescent females: STI or UTI? | journal=J Adolesc Health | year= 2007 | volume= 40 | issue= 5 | pages= 418-24 | pmid=17448399 | doi=10.1016/j.jadohealth.2006.12.010 | pmc=1976261 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17448399 }} </ref><ref name="pmid806017">{{cite journal| author=Eschenbach DA, Buchanan TM, Pollock HM, Forsyth PS, Alexander ER, Lin JS et al.| title=Polymicrobial etiology of acute pelvic inflammatory disease. | journal=N Engl J Med | year= 1975 | volume= 293 | issue= 4 | pages= 166-71 | pmid=806017 | doi=10.1056/NEJM197507242930403 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=806017 }} </ref><ref name="pmid17561186">{{cite journal| author=Risser WL, Risser JM, Benjamins LJ, Feldmann JM| title=Incidence of Fitz-Hugh-Curtis syndrome in adolescents who have pelvic inflammatory disease. | journal=J Pediatr Adolesc Gynecol | year= 2007 | volume= 20 | issue= 3 | pages= 179-80 | pmid=17561186 | doi=10.1016/j.jpag.2006.08.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17561186 }} </ref><ref name="pmid4963696">{{cite journal| author=Rees E| title=Gonococcal bartholinitis. | journal=Br J Vener Dis | year= 1967 | volume= 43 | issue= 3 | pages= 150-6 | pmid=4963696 | doi= | pmc=1047872 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4963696 }} </ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Mucopurulent discharge|Mucopurulent]] uretral, cervical or [[vaginal discharge]] | * [[Mucopurulent discharge|Mucopurulent]] uretral, cervical or [[vaginal discharge]] | ||
| Line 41: | Line 42: | ||
* [[exudates|Pharyngeal exudates]] | * [[exudates|Pharyngeal exudates]] | ||
* [[lymphadenitis|Cervical lymphadenitis]] | * [[lymphadenitis|Cervical lymphadenitis]] | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''Conjunctivitis''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Adult conjunctivitis | |||
**Conjunctival injection | |||
**Purulent eye discharge | |||
**Periorbital edema | |||
**Corneal involvement | |||
*Neonatal Conjunctivitis | |||
**Chemosis | |||
**Severe lid edema | |||
**Mucopurulent discharge | |||
**Corneal involvement | |||
|} | |} | ||
Revision as of 18:58, 22 September 2016
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Gonorrhea Microchapters |
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Gonorrhea physical examination On the Web |
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American Roentgen Ray Society Images of Gonorrhea physical examination |
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Risk calculators and risk factors for Gonorrhea physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Physical examination
The most common site of gonococcal infection is the urethra, endocervix, rectum, and pharynx. Physical examination of patients with gonococcal infection is usually remarkable for:
| Type of Gonorrheal Infection | Physical Examination | ||
|---|---|---|---|
| Urogenital infection in men[1] |
| ||
| Urogenital infection in women:[2][3][4][5][6][7] |
| ||
| Proctitis[8] |
| ||
| Pharyngitis[9][10] | Conjunctivitis |
|
Physical examination of patients with disseminated gonococcal infection is usually remarkable for:
| Disseminated Gonorrheal Infection | Organ systems |
|---|---|
| General Appearance |
Note: Occurs in the acute phase of infection |
| Skin |
|
| Eye |
Note: purulent arthritis may be abrupt onset of monoarthritis or oligoarthritis without skin lesions and fever |
| Musculoskeletal |
Note: purulent arthritis may be abrupt onset of monoarthritis or oligoarthritis without skin lesions and fever
Note: most commonly occurs in hands and less commonly lower extremities
|
| Central Nervous System |
|
| Cardiac |
|
Male
- Purulent or mucopurulent discharge from urethera. The discharge can be demonstrated by milking the shaft of penis.
- Epididymal tenderness and edema usually unilateral
Female Pelvic examination
Inspection
- Purulent or mucopurulent discharge
- Vaginal bleeding
Palpation
- Cervical mucosa may become fragile and bleed even with some manipulation.
- Cervical motion tenderness during bimanual pelvic examination
Gallery
-
![A highly contagious infection, gonococcal ophthalmia is due the pathogenic bacteria Neisseria gonorrhoeae. From Public Health Image Library (PHIL). [11]](/images/8/86/Gonorrhea15.jpeg)
A highly contagious infection, gonococcal ophthalmia is due the pathogenic bacteria Neisseria gonorrhoeae. From Public Health Image Library (PHIL). [11]
-
![This patient presented with gonococcal urethritis, which became systemically disseminated leading to gonococcal conjunctivitis of the right eye. From Public Health Image Library (PHIL). [11]](/images/8/8a/Gonorrhea11.jpeg)
This patient presented with gonococcal urethritis, which became systemically disseminated leading to gonococcal conjunctivitis of the right eye. From Public Health Image Library (PHIL). [11]
-
![Photograph of a gonococcal infection involving the cervix of a patient who presented with a case of gonorrhea. From Public Health Image Library (PHIL). [11]](/images/e/eb/Gonorrhea07.jpeg)
Photograph of a gonococcal infection involving the cervix of a patient who presented with a case of gonorrhea. From Public Health Image Library (PHIL). [11]
![A highly contagious infection, gonococcal ophthalmia is due the pathogenic bacteria Neisseria gonorrhoeae. From Public Health Image Library (PHIL). [11]](/index.php/File:Gonorrhea15.jpeg)
![This patient presented with gonococcal urethritis, which became systemically disseminated leading to gonococcal conjunctivitis of the right eye. From Public Health Image Library (PHIL). [11]](/index.php/File:Gonorrhea11.jpeg)
![Photograph of a gonococcal infection involving the cervix of a patient who presented with a case of gonorrhea. From Public Health Image Library (PHIL). [11]](/index.php/File:Gonorrhea07.jpeg)
References
- ↑ Sherrard J, Barlow D (1996). "Gonorrhoea in men: clinical and diagnostic aspects". Genitourin Med. 72 (6): 422–6. PMC 1195730. PMID 9038638.
- ↑ Workowski KA, Bolan GA, Centers for Disease Control and Prevention (2015). "Sexually transmitted diseases treatment guidelines, 2015". MMWR Recomm Rep. 64 (RR-03): 1–137. PMID 26042815.
- ↑ Barlow D, Phillips I (1978). "Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects". Lancet. 1 (8067): 761–4. PMID 76760.
- ↑ Huppert JS, Biro F, Lan D, Mortensen JE, Reed J, Slap GB (2007). "Urinary symptoms in adolescent females: STI or UTI?". J Adolesc Health. 40 (5): 418–24. doi:10.1016/j.jadohealth.2006.12.010. PMC 1976261. PMID 17448399.
- ↑ Eschenbach DA, Buchanan TM, Pollock HM, Forsyth PS, Alexander ER, Lin JS; et al. (1975). "Polymicrobial etiology of acute pelvic inflammatory disease". N Engl J Med. 293 (4): 166–71. doi:10.1056/NEJM197507242930403. PMID 806017.
- ↑ Risser WL, Risser JM, Benjamins LJ, Feldmann JM (2007). "Incidence of Fitz-Hugh-Curtis syndrome in adolescents who have pelvic inflammatory disease". J Pediatr Adolesc Gynecol. 20 (3): 179–80. doi:10.1016/j.jpag.2006.08.004. PMID 17561186.
- ↑ Rees E (1967). "Gonococcal bartholinitis". Br J Vener Dis. 43 (3): 150–6. PMC 1047872. PMID 4963696.
- ↑ Stansfield VA (1980). "Diagnosis and management of anorectal gonorrhoea in women". Br J Vener Dis. 56 (5): 319–21. PMC 1045815. PMID 7427703.
- ↑ Kraus SJ (1979). "Incidence and therapy of gonococcal pharyngitis". Sex Transm Dis. 6 (2 Suppl): 143–7. PMID 386537.
- ↑ Osborne NG, Grubin L (1979). "Colonization of the pharynx with Neisseria gonorrhoeae: experience in a clinic for sexually transmitted diseases". Sex Transm Dis. 6 (4): 253–6. PMID 119330.
- ↑ 11.0 11.1 11.2 "Public Health Image Library (PHIL)".