Gonorrhea history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Gonorrhea (gonorrhoea in British English) is amongst the most common sexually transmitted diseases in the world and is caused by Gram-negative bacterium Neisseria gonorrheae. The term comes from Ancient Greek γονόρροια (gonórrhoia), literally "flow of seed"; in ancient times it was incorrectly believed that the pus discharge associated with the disease contained semen.[1]
History and symptoms
The incubation time varies from 2 to 14 days with most symptoms occurring between days 2 and 5 after being infected from an infected partner. A small number of people may be asymptomatic for up to a year. Between 30–60% of women with gonorrhea are asymptomatic or have subclinical disease.[2] The woman may complain of vaginal discharge, difficulty urinating (dysuria), off-cycle menstrual bleeding, or bleeding after sexual intercourse. The cervix may appear anywhere from normal to the extreme of marked cervical inflammation (elephantitus) with pus. Infection of the urethra (urethritis) causes little dysuria or pus. The combination of urethritis and cervicitis on examination strongly supports a gonorrhea diagnosis, as both sites are infected in most gonorrhea patients.
More advanced symptoms, which may indicate development of pelvic inflammatory disease (PID), include cramps and pain, bleeding between menstrual periods, vomiting, or fever. It is not unusual for men to have asymptomatic gonorrhea. Men may complain of pain on urinating and thick, copious, urethral pus discharge (also known as gleet) is the most common presentation. Examination may show a reddened external urethral meatus. Ascending infection may involve the epididymis, testicles or prostate gland causing symptoms such as scrotal pain or swelling.
The fact sheet from the Centers for Disease Control (CDC) states, "Many men with gonorrhea may have no symptoms at all, some men have some signs or symptoms that appear two to five days after infection; symptoms can take as long as 30 days to appear. Symptoms and signs include a burning sensation when urinating, or a white, yellow, or green discharge from the penis. Sometimes men with gonorrhea get painful or swollen testicles."
Rectal gonorrhea
Rectal gonorrhea (gonococcal proctitis) may affect both men and women and is often asymptomatic. It may present with anal discharge, pain on defecating and rectal bleeding. Proctoscopy may show an inflamed mucous membrane with little mucus. Rectal infection also may cause no symptoms. It is transmitted by penetrative anal sex and is diagnosed on rectal swab. It cannot be treated with penicillin because rectal commensal bacteria in the rectum produce β-lactamase that protects the gonococcus from penicillin. It is usually contracted from having rough anal sex. It can be avoided by using toys instead.
Gonococcal pharyngitis
Infections of the throat are usually asymptomatic, but in some cases may cause a sore throat. This condition is diagnosed by a throat culture, utilizing a cotton swab; most cases of gonoccal pharyngitis are caused by oral sex with a partner infected with gonorrhea.
References
- ↑ Definition of the term gonorrhea
- ↑ YT van Duynhoven (1999). "The epidemiology of Neisseria gonorrheae in Europe". Microbes and Infection. 1 (6): 455–464. PMID 10602678.