Gonorrhea overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, MBBS [2]
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]
The first place this bacterium infects is usually the columnar epithelium of the urethra and endocervix. Non-genital sites in which it thrives are in the rectum, the oropharynx and the conjunctivae of the eyes. The vulva and vagina in women are usually spared because they are lined by stratified epithelial cells—in women the cervix is the usual first site of infection.
Gonorrhea spreads during sexual intercourse. Infected women also can pass gonorrhea to their newborn infants during delivery, causing eye infections (conjunctivitis) in their babies (which if left untreated, can cause blindness). Doctors have often attempted to treat this immediately by applying small amounts of silver nitrate to the eyes of all newborn babies. Gonorrhea among females can also be transmitted from one individual to another via contact to surfaces that may still be damp from prior contact.
Historical Perspective
Gonorrhea is an ancient disease with Biblical Testament references. However, the exact time of onset of gonorrhea cannot be accurately determined from the historical record.[2] In 1879, gonorrhea was referred to as “the clap” by German bacteriologist Albert Neisser.[3] The first reliable antibiotic (sulfonamides) prove effective against gonorrhea in 1930s.[2]
Slang terms
"The clap"
Gonorrhea is also commonly known by the slang term "the clap". One suggested etymology refers to a traditional treatment used to clear the blockage in the urethra from gonorrheal pus, where the penis would be "clapped" on both sides simultaneously.[4] It could also refer to the painful sting in the male urethra, which feels like the sting of a clap (as in clapping hands) when infected with the disease. Yet another suggested source is from the old French word "clapier", meaning "brothel". Another suggested source for the term is from a notorious 18th century keeper of a brothel, Margaret Clap (better known as "Mother Clap"), though perhaps her name itself was derived from the slang term. This term has, in recent years, come to be used by extension to refer to any unspecified sexually transmitted disease.
Causes
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.[5]
Diagnosis
History and Symptoms
Half of women with gonorrhea are asymptomatic while others have vaginal discharge, lower abdominal pain or pain with intercourse. Most men who are infected have symptoms such as urethritis associated with burning with urination and discharge from the penis. Either sex may also acquire gonorrhea of the throat from performing oral sex on an infected partner, usually a male partner. Such infection is asymptomatic in 90% of cases, and produces a sore throat in the remaining 10%. The incubation period is 2 to 14 days with most of these symptoms occurring between 4–6 days after being infected. Rarely, gonorrhea may cause skin legions and joint infection (pain and swelling in the joints) after traveling through the blood stream. Very rarely it may settle in the heart causing endocarditis or in the spinal column causing meningitis (both are more likely among individuals with suppressed immune systems.
References
- ↑ Definition of the term gonorrhea
- ↑ 2.0 2.1 Genco, Caroline Attardo. Neisseria: molecular mechanisms of pathogenesis. Horizon Scientific Press, 2010.
- ↑ Unemo M, Shafer WM. Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future. Clin Microbiol Rev 2014;27:587–613.
- ↑ http://std-gov.org/stds/gonorrhea.htm
- ↑ Definition of the term gonorrhea