health

Gonorrhoea is caused by infection with Neisseria gonorrhoeae and may involve columnar epithelium in the lower genital tract, rectum, pharynx and eyes. Transmission is usually the result of vaginal, anal or oral sex. Gonococcal conjunctivitis may be the result of accidental infection from contaminated fingers. Untreated mothers may infect their babies during delivery, resulting in ophthalmia neonatorum . Infection of children beyond the neonatal period is usually indicative of sexual abuse

Clinical features

The incubation period is usually 2-10 days. In men the anterior urethra is commonly infected, causing urethral discharge and dysuria, but symptoms are absent in about 10% of cases. Examination will usually show a mucopurulent or purulent urethral discharge. Rectal infection in MSM is usually asymptomatic but may present with anal discomfort, discharge or rectal bleeding. Proctoscopy may reveal either no abnormality, or clinical evidence of proctitis ; cure rates should exceed 95%. Longer courses of antibiotics are required for complicated infection. Partner(s) of patients with gonorrhoea should be seen as soon as possible Delay in treatment may lead to complications COMPLICATIONS OF DELAYED THERAPY IN GONORRHOEA Acute prostatitis Epididymo-orchitis Bartholin's gland abscess PID (may lead to infertility or ectopic pregnancy) Disseminated gonococcal infection