Gonorrhea physical examination: Difference between revisions
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==Physical examination== | ==Physical examination== | ||
===Common Urogenital and Extragenital Infection=== | ===Common Urogenital and Extragenital Infection=== | ||
The most common site of gonococcal infection is the urethra, endocervix, rectum | 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: | ||
Revision as of 12:26, 23 September 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Physical examination
Common Urogenital and Extragenital Infection
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 |
|
Disseminated Gonococcal Infection
Dissemination gonococcal infection can result two clinical syndromes:
- Septic arthritis (purulent arthritis)
- Arthritis-dermatitis syndromes (with a triad of tenosynovitis, dermatitis, and polyarthralgias)
Other less common manifestations of disseminated gonococcal infection include:
- Endocarditis
- Meningitis
- Asteomyelitis
Physical examination of patients with disseminated gonococcal infection is usually remarkable for:
| Disseminated Gonococcal Infection | Organ systems |
|---|---|
| General Appearance |
Note: Occurs in the acute phase of infection |
| Skin |
|
| Eye |
|
| 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)".