Gonorrhea (patient information): Difference between revisions
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'''For the WikiDoc page for this topic, click [[Gonorrhea|here]]''' | '''For the WikiDoc page for this topic, click [[Gonorrhea|here]]''' | ||
{{SI}} | {{SI}} | ||
'''Editor-in-Chief:''' Alexandra M. Palmer | {{CMG}}, '''Associate Editor(s)-in-Chief:''' Alexandra M. Palmer | ||
==Overview== | |||
== | |||
[[Gonorrhea]] is a common [[sexually transmitted disease]] ([[STD]]). | [[Gonorrhea]] is a common [[sexually transmitted disease]] ([[STD]]). | ||
==What are the symptoms of Gonorrhea?== | ==What are the symptoms of Gonorrhea?== | ||
Symptoms of [[gonorrhea]] usually appear 2 - 5 days after [[infection]], however, in men, symptoms may take up to a month to appear. Some people do not have symptoms. They may be completely unaware that they have caught the [[disease]], and therefore do not seek [[treatment]]. This increases the risk of [[complications]] and the chances of passing the [[infection]] on to another person. | Symptoms of [[gonorrhea]] usually appear 2 - 5 days after [[infection]], however, in men, symptoms may take up to a month to appear. Some people do not have symptoms. They may be completely unaware that they have caught the [[disease]], and therefore do not seek [[treatment]]. This increases the risk of [[complications]] and the chances of passing the [[infection]] on to another person. | ||
Symptoms in men include: | Symptoms in men include: | ||
*Burning and [[pain]] while urinating | *Burning and [[pain]] while urinating | ||
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*Tender or swollen [[testicles]] | *Tender or swollen [[testicles]] | ||
*[[Sore throat]] ([[gonococcal pharyngitis]]) | *[[Sore throat]] ([[gonococcal pharyngitis]]) | ||
Symptoms in women can be very mild or nonspecific, and may be mistaken for another type of [[infection]]. They include: | Symptoms in women can be very mild or nonspecific, and may be mistaken for another type of [[infection]]. They include: | ||
*[[Vaginal discharge]] | *[[Vaginal discharge]] | ||
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*Severe [[pain]] in lower [[abdomen]] (if the [[infection]] spreads to the [[fallopian tubes]] and [[stomach]] area) | *Severe [[pain]] in lower [[abdomen]] (if the [[infection]] spreads to the [[fallopian tubes]] and [[stomach]] area) | ||
*[[Fever]] (if the [[infection]] spreads to the [[fallopian tubes]] and [[stomach]] area) | *[[Fever]] (if the [[infection]] spreads to the [[fallopian tubes]] and [[stomach]] area) | ||
If the [[infection]] spreads to the [[bloodstream]], [[fever]], [[rash]], and [[arthritis]]-like symptoms may occur. | If the [[infection]] spreads to the [[bloodstream]], [[fever]], [[rash]], and [[arthritis]]-like symptoms may occur. | ||
==What causes Gonorrhea?== | ==What causes Gonorrhea?== | ||
[[Gonorrhea]] is caused by the [[bacteria]] [[Neisseria gonorrhoeae]]. Anyone who has any type of sex can catch [[gonorrhea]]. The [[infection]] can be spread by contact with the [[mouth]], [[vagina]], [[penis]], or [[anus]]. | [[Gonorrhea]] is caused by the [[bacteria]] [[Neisseria gonorrhoeae]]. Anyone who has any type of sex can catch [[gonorrhea]]. The [[infection]] can be spread by contact with the [[mouth]], [[vagina]], [[penis]], or [[anus]]. | ||
The [[bacteria]] grow in warm, moist areas of the body, including the tube that carries [[urine]] out of the body ([[urethra]]). In women, the [[bacteria]] may be found in the [[reproductive]] tract (which includes the [[fallopian tubes]], [[uterus]], and [[cervix]]). The [[bacteria]] can even grow in the [[eyes]]. | The [[bacteria]] grow in warm, moist areas of the body, including the tube that carries [[urine]] out of the body ([[urethra]]). In women, the [[bacteria]] may be found in the [[reproductive]] tract (which includes the [[fallopian tubes]], [[uterus]], and [[cervix]]). The [[bacteria]] can even grow in the [[eyes]]. | ||
[[Health care providers]] in every state in the U.S. are required by law to tell their State Board of Health about anyone diagnosed with [[gonorrhea]]. The goal of this law is to make sure the patient gets proper follow-up care and that their sexual partners are found and tested. | [[Health care providers]] in every state in the U.S. are required by law to tell their State Board of Health about anyone diagnosed with [[gonorrhea]]. The goal of this law is to make sure the patient gets proper follow-up care and that their sexual partners are found and tested. | ||
More than 700,000 persons in the United States get [[gonorrhea]] every year, according to the Centers for Disease Control and Prevention (CDC). | More than 700,000 persons in the United States get [[gonorrhea]] every year, according to the Centers for Disease Control and Prevention (CDC). | ||
[[Gonorrhea]] is more common in large cities, inner-city areas, populations with lower overall levels of education and people with lower socioeconomic status. | [[Gonorrhea]] is more common in large cities, inner-city areas, populations with lower overall levels of education and people with lower socioeconomic status. | ||
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==How do I know I have Gonorrhea?== | ==How do I know I have Gonorrhea?== | ||
[[Gonorrhea]] can be quickly identified by staining a sample of [[tissue]] or discharge and then looking at it under a [[microscope]]. This is called a [[gram stain]]. Although this method is fast, it is not the most certain. | [[Gonorrhea]] can be quickly identified by staining a sample of [[tissue]] or discharge and then looking at it under a [[microscope]]. This is called a [[gram stain]]. Although this method is fast, it is not the most certain. | ||
[[Gram stain]] tests used to diagnose [[gonorrhea]] include: | [[Gram stain]] tests used to diagnose [[gonorrhea]] include: | ||
*[[Cervical]] [[gram stain]] in women | *[[Cervical]] [[gram stain]] in women | ||
*[[Gram stain]] of [[urethral]] discharge in men | *[[Gram stain]] of [[urethral]] discharge in men | ||
*[[Joint]] fluid [[gram stain]] | *[[Joint]] fluid [[gram stain]] | ||
Cultures ([[cells]] that grow in a lab dish) provide absolute proof of [[infection]]. Generally, samples for a culture are taken from the [[cervix]], [[vagina]], [[urethra]], [[anus]], or [[throat]]. Cultures can provide a preliminary [[diagnosis]] often within 24 hours and a confirmed [[diagnosis]] within 72 hours. | Cultures ([[cells]] that grow in a lab dish) provide absolute proof of [[infection]]. Generally, samples for a culture are taken from the [[cervix]], [[vagina]], [[urethra]], [[anus]], or [[throat]]. Cultures can provide a preliminary [[diagnosis]] often within 24 hours and a confirmed [[diagnosis]] within 72 hours. | ||
Cultures used to diagnose [[gonorrhea]] include: | Cultures used to diagnose [[gonorrhea]] include: | ||
*Endocervical culture in women | *Endocervical culture in women | ||
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*Culture of [[joint]] fluid | *Culture of [[joint]] fluid | ||
*[[Blood cultures]] | *[[Blood cultures]] | ||
[[DNA]] tests are especially useful as a [[screening test]]. They included the [[ligase chain reaction]] ([[LCR]]) test. [[DNA]] tests are quicker than cultures. Such tests can be performed on [[urine]] samples, which are a lot easier to collect than samples from the [[genital]] area. | [[DNA]] tests are especially useful as a [[screening test]]. They included the [[ligase chain reaction]] ([[LCR]]) test. [[DNA]] tests are quicker than cultures. Such tests can be performed on [[urine]] samples, which are a lot easier to collect than samples from the [[genital]] area. | ||
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==Prevention of Gonorrhea== | ==Prevention of Gonorrhea== | ||
Not having [[sexual intercourse]] ([[abstinence]]) is the only absolute method of preventing [[gonorrhea]]. A monogamous sexual relationship with an individual known to be free of any [[STD]] can reduce risk. Monogamous means you and your partner do not have sex with any other persons. | Not having [[sexual intercourse]] ([[abstinence]]) is the only absolute method of preventing [[gonorrhea]]. A monogamous sexual relationship with an individual known to be free of any [[STD]] can reduce risk. Monogamous means you and your partner do not have sex with any other persons. | ||
You can greatly lower your risk of catching an [[STD]] by using a [[condom]] every time you have sex. [[Condoms]] are available for both men and women, but are most commonly worn by the man. A [[condom]] must be used properly every time. | You can greatly lower your risk of catching an [[STD]] by using a [[condom]] every time you have sex. [[Condoms]] are available for both men and women, but are most commonly worn by the man. A [[condom]] must be used properly every time. | ||
To further prevent the spread of [[infection]], [[treatment]] of all sexual partners is important. | To further prevent the spread of [[infection]], [[treatment]] of all sexual partners is important. | ||
==Treatment options== | ==Treatment options== | ||
There are two goals in treating a [[sexually transmitted disease]], especially one as easily spread as [[gonorrhea]]. The first is to [[cure]] the [[infection]] in the patient. The second is to locate and test all of the other people the person had sexual contact with and treat them to prevent further spread of the [[disease]]. | There are two goals in treating a [[sexually transmitted disease]], especially one as easily spread as [[gonorrhea]]. The first is to [[cure]] the [[infection]] in the patient. The second is to locate and test all of the other people the person had sexual contact with and treat them to prevent further spread of the [[disease]]. | ||
Never treat yourself without being seen by your doctor first. Your [[health care provider]] will determine the best and most up-to-date [[treatment]]. The U.S. Centers for Disease Control and Prevention (CDC) recommends the following treatments for uncomplicated [[gonorrhea]]. | Never treat yourself without being seen by your doctor first. Your [[health care provider]] will determine the best and most up-to-date [[treatment]]. The U.S. Centers for Disease Control and Prevention (CDC) recommends the following treatments for uncomplicated [[gonorrhea]]. | ||
*A single shot of [[ceftriaxone]] ([[Rocephin]]) 125 mg or a single [[dose]] of [[cefixime]] 400 mg taken by [[mouth]] are currently the recommended [[antibiotic]] [[treatment]] | *A single shot of [[ceftriaxone]] ([[Rocephin]]) 125 mg or a single [[dose]] of [[cefixime]] 400 mg taken by [[mouth]] are currently the recommended [[antibiotic]] [[treatment]] | ||
*[[Azithromycin]] ([[Zithromax]]) 2g in a single [[dose]] may be used for people who have severe [[allergic reactions]] to [[ceftriaxone]], [[cefixime]], or [[penicillin]]. | *[[Azithromycin]] ([[Zithromax]]) 2g in a single [[dose]] may be used for people who have severe [[allergic reactions]] to [[ceftriaxone]], [[cefixime]], or [[penicillin]]. | ||
[[Penicillin]] used to be the standard [[treatment]], but it is not used any longer because it does not cure [[gonorrhea]] all the time. The CDC also recommends against using a class of [[antibiotics]] called [[fluoroquinolones]] ([[ciprofloxacin]], [[ofloxacin]], or [[levofloxacin]]). | [[Penicillin]] used to be the standard [[treatment]], but it is not used any longer because it does not cure [[gonorrhea]] all the time. The CDC also recommends against using a class of [[antibiotics]] called [[fluoroquinolones]] ([[ciprofloxacin]], [[ofloxacin]], or [[levofloxacin]]). | ||
Persons with [[gonorrhea]] often also have a [[chlamydia]] [[infection]]. If a [[chlamydia]] culture was not done to rule out this [[infection]], a single [[dose]] of [[azithromycin]] (1g by [[mouth]]) or [[doxycycline]] 100 mg twice a day, by [[mouth]] for 7 days should also be given. | Persons with [[gonorrhea]] often also have a [[chlamydia]] [[infection]]. If a [[chlamydia]] culture was not done to rule out this [[infection]], a single [[dose]] of [[azithromycin]] (1g by [[mouth]]) or [[doxycycline]] 100 mg twice a day, by [[mouth]] for 7 days should also be given. | ||
A follow-up visit 7 days after [[treatment]] is important if [[joint]] [[pain]], [[skin rash]], or more severe [[pelvic]] or belly [[pain]] is present. Tests will be done to make sure the [[infection]] is gone. | A follow-up visit 7 days after [[treatment]] is important if [[joint]] [[pain]], [[skin rash]], or more severe [[pelvic]] or belly [[pain]] is present. Tests will be done to make sure the [[infection]] is gone. | ||
All sexual contacts of the person with [[gonorrhea]] should be contacted and tested. This helps prevent further spread of the [[disease]]. In some places you may be able to take counseling information and medicines to your sexual partner yourself. In other places, the health department will contact your partner. | All sexual contacts of the person with [[gonorrhea]] should be contacted and tested. This helps prevent further spread of the [[disease]]. In some places you may be able to take counseling information and medicines to your sexual partner yourself. In other places, the health department will contact your partner. | ||
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*Painful [[intercourse]] ([[dyspareunia]]) | *Painful [[intercourse]] ([[dyspareunia]]) | ||
*[[Pregnant]] women with severe [[gonorrhea]] may pass the [[disease]] to their baby while in the [[womb]] or during delivery | *[[Pregnant]] women with severe [[gonorrhea]] may pass the [[disease]] to their baby while in the [[womb]] or during delivery | ||
[[Complications]] in men may include: | [[Complications]] in men may include: | ||
*[[Scarring]] or narrowing of the [[urethra]], the tube that carries [[urine]] out of the body | *[[Scarring]] or narrowing of the [[urethra]], the tube that carries [[urine]] out of the body | ||
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*[[Urinary tract infection]] | *[[Urinary tract infection]] | ||
*[[Kidney failure]] | *[[Kidney failure]] | ||
[[Complications]] in both men and women may include: | [[Complications]] in both men and women may include: | ||
*Disseminated [[infection]], which can be very serious | *Disseminated [[infection]], which can be very serious | ||
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{{WS}} | {{WS}} | ||
[[Category:Patient Information]] | [[Category:Patient Information]] | ||
[[Category:Sexually transmitted diseases]] | |||
[[Category:Sexually transmitted infections]] | |||
[[Category:Infectious disease]] | |||
[[Category:Mature chapter]] | |||
[[Category:Medicine]] | |||
Revision as of 22:02, 29 July 2011
For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Alexandra M. Palmer
Overview
Gonorrhea is a common sexually transmitted disease (STD).
What are the symptoms of Gonorrhea?
Symptoms of gonorrhea usually appear 2 - 5 days after infection, however, in men, symptoms may take up to a month to appear. Some people do not have symptoms. They may be completely unaware that they have caught the disease, and therefore do not seek treatment. This increases the risk of complications and the chances of passing the infection on to another person. Symptoms in men include:
- Burning and pain while urinating
- Increased urinary frequency or urgency
- Discharge from the penis (white, yellow, or green in color)
- Red or swollen opening of penis (urethra)
- Tender or swollen testicles
- Sore throat (gonococcal pharyngitis)
Symptoms in women can be very mild or nonspecific, and may be mistaken for another type of infection. They include:
- Vaginal discharge
- Burning and pain while urinating
- Increased urination
- Sore throat
- Painful sexual intercourse
- Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and stomach area)
- Fever (if the infection spreads to the fallopian tubes and stomach area)
If the infection spreads to the bloodstream, fever, rash, and arthritis-like symptoms may occur.
What causes Gonorrhea?
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. Anyone who has any type of sex can catch gonorrhea. The infection can be spread by contact with the mouth, vagina, penis, or anus. The bacteria grow in warm, moist areas of the body, including the tube that carries urine out of the body (urethra). In women, the bacteria may be found in the reproductive tract (which includes the fallopian tubes, uterus, and cervix). The bacteria can even grow in the eyes. Health care providers in every state in the U.S. are required by law to tell their State Board of Health about anyone diagnosed with gonorrhea. The goal of this law is to make sure the patient gets proper follow-up care and that their sexual partners are found and tested. More than 700,000 persons in the United States get gonorrhea every year, according to the Centers for Disease Control and Prevention (CDC). Gonorrhea is more common in large cities, inner-city areas, populations with lower overall levels of education and people with lower socioeconomic status.
Who is at risk for Gonorrhea?
You are more likely to develop this infection if you:
- Have multiple sexual partners
- Have a partner with a past history of any sexually transmitted disease
- Do not use a condom during sex
- Are a man who has sexual contact with another man
- Have a drug addiction
How do I know I have Gonorrhea?
Gonorrhea can be quickly identified by staining a sample of tissue or discharge and then looking at it under a microscope. This is called a gram stain. Although this method is fast, it is not the most certain. Gram stain tests used to diagnose gonorrhea include:
- Cervical gram stain in women
- Gram stain of urethral discharge in men
- Joint fluid gram stain
Cultures (cells that grow in a lab dish) provide absolute proof of infection. Generally, samples for a culture are taken from the cervix, vagina, urethra, anus, or throat. Cultures can provide a preliminary diagnosis often within 24 hours and a confirmed diagnosis within 72 hours. Cultures used to diagnose gonorrhea include:
- Endocervical culture in women
- Urethral discharge culture in men
- Throat swab culture in both men and women
- Rectal culture in both men and women
- Culture of joint fluid
- Blood cultures
DNA tests are especially useful as a screening test. They included the ligase chain reaction (LCR) test. DNA tests are quicker than cultures. Such tests can be performed on urine samples, which are a lot easier to collect than samples from the genital area.
When to seek urgent medical care
If you have symptoms suggestive of gonorrhea, you should call your health care provider immediately. Most state-sponsored clinics will diagnose and treat STDs without charge.
Prevention of Gonorrhea
Not having sexual intercourse (abstinence) is the only absolute method of preventing gonorrhea. A monogamous sexual relationship with an individual known to be free of any STD can reduce risk. Monogamous means you and your partner do not have sex with any other persons. You can greatly lower your risk of catching an STD by using a condom every time you have sex. Condoms are available for both men and women, but are most commonly worn by the man. A condom must be used properly every time. To further prevent the spread of infection, treatment of all sexual partners is important.
Treatment options
There are two goals in treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infection in the patient. The second is to locate and test all of the other people the person had sexual contact with and treat them to prevent further spread of the disease. Never treat yourself without being seen by your doctor first. Your health care provider will determine the best and most up-to-date treatment. The U.S. Centers for Disease Control and Prevention (CDC) recommends the following treatments for uncomplicated gonorrhea.
- A single shot of ceftriaxone (Rocephin) 125 mg or a single dose of cefixime 400 mg taken by mouth are currently the recommended antibiotic treatment
- Azithromycin (Zithromax) 2g in a single dose may be used for people who have severe allergic reactions to ceftriaxone, cefixime, or penicillin.
Penicillin used to be the standard treatment, but it is not used any longer because it does not cure gonorrhea all the time. The CDC also recommends against using a class of antibiotics called fluoroquinolones (ciprofloxacin, ofloxacin, or levofloxacin). Persons with gonorrhea often also have a chlamydia infection. If a chlamydia culture was not done to rule out this infection, a single dose of azithromycin (1g by mouth) or doxycycline 100 mg twice a day, by mouth for 7 days should also be given. A follow-up visit 7 days after treatment is important if joint pain, skin rash, or more severe pelvic or belly pain is present. Tests will be done to make sure the infection is gone. All sexual contacts of the person with gonorrhea should be contacted and tested. This helps prevent further spread of the disease. In some places you may be able to take counseling information and medicines to your sexual partner yourself. In other places, the health department will contact your partner.
Where to find medical care for Gonorrhea
Directions to Hospitals Treating Gonorrhea
Possible complications
Complications in women may include:
- Salpingitis (scarring of the fallopian tubes), which can lead to problems getting pregnant or ectopic pregnancy
- Pelvic inflammatory disease
- Sterility (inability to become pregnant)
- Painful intercourse (dyspareunia)
- Pregnant women with severe gonorrhea may pass the disease to their baby while in the womb or during delivery
Complications in men may include:
- Scarring or narrowing of the urethra, the tube that carries urine out of the body
- Abscess (collection of pus around the urethra)
- Urination problems
- Urinary tract infection
- Kidney failure
Complications in both men and women may include:
- Disseminated infection, which can be very serious
- Long-term joint pain, if the infection is left untreated
- Heart valve infection
- Meningitis