Gonorrhea pathophysiology
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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
Pathophysiology
Gonorrhea is a sexually transmitted disease (STD) that is caused by a gram negative diplococcus (Neisseria gonorrhea). It can infect both men and women.
The recognized routes of transmission of the Neisseria gonorrhoeae include:
- Male to female via semen. The transmission rate is estimated to be 50%-70% per episode of vaginal intercourse
- Female vagina to male urethra. The transmission rate is estimated to be 20% per episode of vaginal intercourse and increases to 60%-80% after 4 or more exposures.
- Rectal intercourse
- Fellatio and less commonly cunnilingus can result in pharyngeal gonorrhea
- Perinatal transmission
The main pathogenicity of the Neisseria gonorrhea obtains from the surface pili. The pili helps Neisseria gonorrhea to attach on the surface of the urethra, fallopian tubes and endocervix and survive the host defiance mechanism by following methods:
- Preventing phagocytosis by neutrophils
- Producing IgA protease
- In pregnancy, gonococcus can be transmitted to the fetus at the time of delivery. This results in infection of the conjuctiva. This appears 1 to 4 days after birth as severe discharge with marked swelling and redness of the eyelids and conjunctiva.
Associated Conditions
HIVinfection
Gonorrhea is associated with increased susceptibility to the transmission of HIV infection. It is thought, gonorrhea infections can result in the increase HIV shedding in individuals.