Gonorrhea physical examination
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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
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 |
|
| 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 |
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| 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
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![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]
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![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]
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![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)".