Gonorrhea history and symptoms: Difference between revisions

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{{Gonorrhea}}
{{Gonorrhea}}
 
{{CMG}}; {{AE}} {{SaraM}}, [[Priyamvada Singh|Priyamvada Singh, MBBS]] [mailto:psingh13579@gmail.com]
{{CMG}}; '''Associate Editors-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, MBBS]] [mailto:psingh@perfuse.org]


==Overview==
==Overview==
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.
It is critical to obtain a detailed and thorough sexual history from the patient. Specific areas of focus when obtaining a history from a patient include number and type of sexual partners, contraception use, and previous history of [[sexually transmitted diseases]]. The majority of women with gonorrhea are asymptomatic, while others have [[vaginal discharge]], lower [[abdominal pain]], or pain during sexual intercourse. Common symptom of gonococcal infection in men include [[urethritis]], which is 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.<ref name="pmid26042815">{{cite journal| author=Workowski KA, Bolan GA, Centers for Disease Control and Prevention| title=Sexually transmitted diseases treatment guidelines, 2015. | journal=MMWR Recomm Rep | year= 2015 | volume= 64 | issue= RR-03 | pages= 1-137 | pmid=26042815 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26042815  }} </ref><ref name="pmid9038638">{{cite journal| author=Sherrard J, Barlow D| title=Gonorrhoea in men: clinical and diagnostic aspects. | journal=Genitourin Med | year= 1996 | volume= 72 | issue= 6 | pages= 422-6 | pmid=9038638 | doi= | pmc=1195730 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9038638  }} </ref><ref name="pmid76760">{{cite journal| author=Barlow D, Phillips I| title=Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects. | journal=Lancet | year= 1978 | volume= 1 | issue= 8067 | pages= 761-4 | pmid=76760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=76760  }} </ref><ref name="pmid119330">{{cite journal| author=Osborne NG, Grubin L| title=Colonization of the pharynx with Neisseria gonorrhoeae: experience in a clinic for sexually transmitted diseases. | journal=Sex Transm Dis | year= 1979 | volume= 6 | issue= 4 | pages= 253-6 | pmid=119330 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=119330  }} </ref> Rarely, gonorrhea may cause [[skin lesions]] 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]].<ref name="pmid16297736">{{cite journal| author=Rice PA| title=Gonococcal arthritis (disseminated gonococcal infection). | journal=Infect Dis Clin North Am | year= 2005 | volume= 19 | issue= 4 | pages= 853-61 | pmid=16297736 | doi=10.1016/j.idc.2005.07.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16297736  }} </ref>
 
==History==
In patients with suspected sexually transmitted diseases the following history should be sought:
 
* Past history of similar symptoms or STDs in patient, current or past partners


* Type of contraception used
==History and Symptoms==
===History===
It is critical to obtain a detailed and thorough sexual history from the patient.
In patients with suspected [[sexually transmitted diseases]], the following aspects of the patient's history should be sought:<ref name="pmid26042815">{{cite journal| author=Workowski KA, Bolan GA, Centers for Disease Control and Prevention| title=Sexually transmitted diseases treatment guidelines, 2015. | journal=MMWR Recomm Rep | year= 2015 | volume= 64 | issue= RR-03 | pages= 1-137 | pmid=26042815 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26042815  }} </ref><ref name="pmid9038638">{{cite journal| author=Sherrard J, Barlow D| title=Gonorrhoea in men: clinical and diagnostic aspects. | journal=Genitourin Med | year= 1996 | volume= 72 | issue= 6 | pages= 422-6 | pmid=9038638 | doi= | pmc=1195730 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9038638  }} </ref><ref name="pmid76760">{{cite journal| author=Barlow D, Phillips I| title=Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects. | journal=Lancet | year= 1978 | volume= 1 | issue= 8067 | pages= 761-4 | pmid=76760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=76760  }} </ref>
* Number and type of sexual partners
* Previous history of gonococcal infection or other [[sexually transmitted diseases]]
* Past history of similar symptoms or STDs in patient and current or past partners
* Type of [[contraception]] used
* History of sexual assault
* Reproductive history
** Details of parity including any history of ectopic pregnancies
** Timing of the last [[menstrual period]]
** Assessing the possibility of [[pregnancy]]


* History of sexual assault.
===Symptoms===
 
====Common urogenital and extragenital Infection====
* Menstrual history (date of the last menstrual period, duration. intermittent bleeding, pain)
* Between 30–60% of women with gonorrhea are [[asymptomatic]] or have [[wiktionary:subclinical|subclinical]] disease.<ref name="pmid10602678">{{cite journal| author=van Duynhoven YT| title=The epidemiology of Neisseria gonorrhoeae in Europe. | journal=Microbes Infect | year= 1999 | volume= 1 | issue= 6 | pages= 455-64 | pmid=10602678 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10602678  }} </ref>
 
* Reproductive history (details of parity, including any history of ectopic pregnancies)
 
==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.
* 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. They may be completely unaware that they have caught the [[disease]], and therefore do not seek [[treatment]]. This increases the risk of [[complications]] and the chances of passing the [[infection]] on to another person.
* A small number of people may be [[asymptomatic]] for up to a year. They may be completely unaware that they have caught the [[disease]], and therefore do not seek [[treatment]]. This increases the risk of [[complications]] and the chances of passing the [[infection]] on to another person.
* Between 30–60% of women with gonorrhea are [[asymptomatic]] or have [[wiktionary:subclinical|subclinical]] disease.<ref name=duynhoven>
Common symptoms of urogenital and extragenital gonococcal Infection may include the following:<ref name="pmid26042815">{{cite journal| author=Workowski KA, Bolan GA, Centers for Disease Control and Prevention| title=Sexually transmitted diseases treatment guidelines, 2015. | journal=MMWR Recomm Rep | year= 2015 | volume= 64 | issue= RR-03 | pages= 1-137 | pmid=26042815 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26042815  }} </ref><ref name="pmid9038638">{{cite journal| author=Sherrard J, Barlow D| title=Gonorrhoea in men: clinical and diagnostic aspects. | journal=Genitourin Med | year= 1996 | volume= 72 | issue= 6 | pages= 422-6 | pmid=9038638 | doi= | pmc=1195730 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9038638  }} </ref><ref name="pmid76760">{{cite journal| author=Barlow D, Phillips I| title=Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects. | journal=Lancet | year= 1978 | volume= 1 | issue= 8067 | pages= 761-4 | pmid=76760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=76760  }} </ref><ref name="pmid119330">{{cite journal| author=Osborne NG, Grubin L| title=Colonization of the pharynx with Neisseria gonorrhoeae: experience in a clinic for sexually transmitted diseases. | journal=Sex Transm Dis | year= 1979 | volume= 6 | issue= 4 | pages= 253-6 | pmid=119330 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=119330  }} </ref><ref name="pmid7427703">{{cite journal| author=Stansfield VA| title=Diagnosis and management of anorectal gonorrhoea in women. | journal=Br J Vener Dis | year= 1980 | volume= 56 | issue= 5 | pages= 319-21 | pmid=7427703 | doi= | pmc=1045815 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7427703  }} </ref><ref name="pmid386537">{{cite journal| author=Kraus SJ| title=Incidence and therapy of gonococcal pharyngitis. | journal=Sex Transm Dis | year= 1[[Link title]]979 | volume= 6 | issue= 2 Suppl | pages= 143-7 | pmid=386537 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=386537  }} </ref>
{{cite journal | author=YT van Duynhoven | title=The epidemiology of Neisseria gonorrheae in Europe | journal=Microbes and Infection | year=1999 | pages=455–464 | volume=1 | issue=6 | id={{PMID |10602678}}}}</ref>
 
==Genitourinary==
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
===Male===
|+
* Thick, copious, white, yellow, or green colored discharge from [[penis]] (also known as ''[[Wiktionary:gleet|gleet]]'') is the most common presentation.
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Type of Gonococcal Infection}}
! style="background: #4479BA; width: 500px;" | {{fontcolor|#FFF|Symptoms}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Images<ref>STD Gonorrhea Infection Gallery http://www.std-gov.org/std_picture/gonorrhea_w.htm Accessed on September 22, 2016</ref><ref name=CDCGonorrheapic>Centers for Disease Control and Prevention. Public Health Image Library (PHIL) http://phil.cdc.gov/phil/details.asp Accessed on September 22, 2016</ref>}}
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Male Genitourinary'''
| style="padding: 5px 5px; background: #F5F5F5;" |
* Thick, copious, white, yellow, or green colored discharge from [[penis]]  
* Burning and [[pain]] while urinating
* Burning and [[pain]] while urinating
* Increased urinary frequency or urgency
* Urinary frequency or urgency
* Painful or swollen [[testicles]]
* Painful or swollen [[testicles]]
* [[Scrotum|scrotal]] pain or swelling.
* [[Scrotum|scrotal]] pain or swelling
* Decreased or abnormal urine stream may suggest stricture (gonorrheal stricture are uncommon these days)
* Decreased or abnormal urine stream may suggest stricture
 
| style="padding: 5px 5px; background: #F5F5F5;" |
===Female===
<gallery> Image:Gonorrhea penile discharge.jpg|Penile discharge in a patient with gonorrhea - Source: https://www.std.gov/</gallery>
Symptoms in women can be very mild or nonspecific, and may be mistaken for another type of [[infection]]. However, even asymptomatic females are prone to have complications due to gonorrheal infection. The symptoms include:
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Female Genitourinary'''
| style="padding: 5px 5px; background: #F5F5F5;" |
* Often asymptomatic (40-60%)
* [[Vaginal discharge]] (thin, purulent, and mildly odorous)
* [[Vaginal discharge]] (thin, purulent, and mildly odorous)
* Painful [[sexual intercourse]]
* [[Dyspareunia]]  
* Off-cycle [[Menstrual cycle|menstrual]] bleeding, or bleeding after sexual intercourse.
* Spotting
* Increased frequency of urination.
* Bleeding after sexual intercourse
* Burning and [[pain]] while urinating
* Urinary frequency and urgency
* Severe [[pain]] in lower abdomen, fever, nausea, vomiting (if the [[infection]] spreads to the [[fallopian tubes, ovaries, endometrium]] 
* [[Dysuria]]  
* If the [[infection]] spreads to the [[bloodstream]], [[fever]], vomiting, [[rash]], and [[arthritis]]-like symptoms may occur.
* Severe lower abdomen [[pain]] (if the [[infection]] spreads to the [[fallopian tubes]], [[ovaries]], [[endometrium]])
* Pain on right upper side of abdomen (right upper quadrant) may occur due to inflammation of liver (perihepatitis)
| style="padding: 5px 5px; background: #F5F5F5;" |
 
|-
==Gonococcal proctitis (Rectal)==
| style="padding: 5px 5px; background: #DCDCDC;" | '''Gonococcal proctitis (Rectal)'''
* It is usually contracted from having rough [[anal sex]]. It can be avoided by using toys instead. It may affect both men and women
| style="padding: 5px 5px; background: #F5F5F5;" |
* Often asymptomatic
* Often asymptomatic
* Anal discharge
* Anal discharge
* Pain on defecating
* Pain on defecating
* Rectal bleeding.
* Rectal bleeding
* Pruritus
* [[Pruritus]]
* Tenesmus
* [[Tenesmus]]
* Bloody diarrhea
* Bloody diarrhea
 
| style="padding: 5px 5px; background: #F5F5F5;" |
==Gonococcal pharyngitis==
|-
* Caused by [[oral sex]] with a partner infected with gonorrhea.
| style="padding: 5px 5px; background: #DCDCDC;" | '''Gonococcal pharyngitis'''
| style="padding: 5px 5px; background: #F5F5F5;" |
* Usually asymptomatic
* Usually asymptomatic
* Sore throat
* Mild to sever sore throat
==Gonococcal conjunctivitis (ophthalmia neonatorum)==
| style="padding: 5px 5px; background: #F5F5F5;" |
* Bilateral conjunctivitis (redness, discharge, and pain in eyes) is usually seen in neonates and is acquired during vaginal birth from the untreated, infected mother.
|-
* It can lead to complications like blindness if not treated promptly.
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Ophthalmia neonatorum]]'''
* Secondary gonococcal bacterial conjunctivitis may follow accidental inoculation by fingers in either sex and is usually unilateral.
| style="padding: 5px 5px; background: #F5F5F5;" |
* Occurs within 2-5 days after birth
* Severe white bilateral discharge
* Tearing
* Eyelids swellings
| style="padding: 5px 5px; background: #F5F5F5;" |
<gallery> Image:220px-Gonococcal_ophthalmia_neonatorum.jpg|Neonatal conjunctivitis - Source: https://www.cdc.gov/</gallery>
|}


==Gonorrhea endocarditis, Meningitis==
====Disseminated gonococcal infection====
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.
Symptoms of disseminated gonorrheal infection may include the following:<ref name="pmid22353959">{{cite journal| author=Bleich AT, Sheffield JS, Wendel GD, Sigman A, Cunningham FG| title=Disseminated gonococcal infection in women. | journal=Obstet Gynecol | year= 2012 | volume= 119 | issue= 3 | pages= 597-602 | pmid=22353959 | doi=10.1097/AOG.0b013e318244eda9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22353959  }} </ref><ref name="pmid6415361">{{cite journal| author=O'Brien JP, Goldenberg DL, Rice PA| title=Disseminated gonococcal infection: a prospective analysis of 49 patients and a review of pathophysiology and immune mechanisms. | journal=Medicine (Baltimore) | year= 1983 | volume= 62 | issue= 6 | pages= 395-406 | pmid=6415361 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6415361  }} </ref><ref name="pmid16297736">{{cite journal| author=Rice PA| title=Gonococcal arthritis (disseminated gonococcal infection). | journal=Infect Dis Clin North Am | year= 2005 | volume= 19 | issue= 4 | pages= 853-61 | pmid=16297736 | doi=10.1016/j.idc.2005.07.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16297736  }} </ref>


<div align="center">
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
<gallery heights="175" widths="175">
|+
Image:Gonorehea-skin-lesion.jpg|Skin lesion on foot in a patient with Gonorrhea
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Type of Disseminated gonorrheal infection}}
Image:Ophthalmia neonatorum (gonococcal conjunctivitis).jpg|Gonococcal infection of the conjunctiva in a neonate
! style="background: #4479BA; width: 500px;" | {{fontcolor|#FFF|Symptoms}}
Image:Gonorrhea penile discharge.jpg||Penile discharge in a patient with Gonorrhea
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Images<ref name=CDCGonorrheapic>Centers for Disease Control and Prevention. Public Health Image Library (PHIL) http://phil.cdc.gov/phil/details.asp Accessed on September 22, 2016</ref><ref>STD Gonorrhea Infection Gallery http://www.std-gov.org/std_picture/gonorrhea_w.htm Accessed on September 22, 2016</ref>}}
Image:Gonorrhea-epididymitis.jpg||Swollen testes consistent with epididymitis in a patient with Gonorrhea
|-
</gallery>
| style="padding: 5px 5px; background: #DCDCDC;" | '''Arthritis Dermatitis Syndrome'''
</div>
| style="padding: 5px 5px; background: #F5F5F5;" |
*Asymptomatic genitourinary
*Joint or tendon pain 
**[[Monoarthralgia]]
**Migratory [[Polyarthralgia]]
**tenosynovitis
*Rash commonly found below neck, palm and sole
*Fever
| style="padding: 5px 5px; background: #F5F5F5;" |
<gallery> Image:Gonorehea-skin-lesion.jpg|Skin lesion on foot in a patient with DGI - Source: https://www.cdc.gov/</gallery>
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Septic arthritis'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Abrupt onset of arthritis (Knees, wrists, and ankles)
**Monoarthritis
**[[Oligoarthritis]]
*Without skin lesion
| style="padding: 5px 5px; background: #F5F5F5;" |
<gallery>Image:Gonorrhea34.jpg|Gonococcal arthritis - Source: https://www.std.gov/</gallery>
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Gonorrhea Meningitis'''
| style="padding: 5px 5px; background: #F5F5F5;" |
* As a rare complications of DGI
* Headache
* Neck pain and stiffness
* Fever
* Decreased sensorium may indicate gonococcal meningitis
| style="padding: 5px 5px; background: #F5F5F5;" |
<gallery> Image:</gallery>
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Gonorrhea Endocarditis'''
| style="padding: 5px 5px; background: #F5F5F5;" |
* As a rare complications of DGI
* Very rarely it may settle in the heart causing endocarditis
* Fever and chills
* Malaise
* Atypical chest pain
| style="padding: 5px 5px; background: #F5F5F5;" |
<gallery> Image:</gallery>
|}


==References==
==References==
<references/>
{{Reflist|2}}


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Latest revision as of 21:55, 29 July 2020

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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], Priyamvada Singh, MBBS [3]

Overview

It is critical to obtain a detailed and thorough sexual history from the patient. Specific areas of focus when obtaining a history from a patient include number and type of sexual partners, contraception use, and previous history of sexually transmitted diseases. The majority of women with gonorrhea are asymptomatic, while others have vaginal discharge, lower abdominal pain, or pain during sexual intercourse. Common symptom of gonococcal infection in men include urethritis, which is 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.[1][2][3][4] Rarely, gonorrhea may cause skin lesions 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.[5]

History and Symptoms

History

It is critical to obtain a detailed and thorough sexual history from the patient. In patients with suspected sexually transmitted diseases, the following aspects of the patient's history should be sought:[1][2][3]

  • Number and type of sexual partners
  • Previous history of gonococcal infection or other sexually transmitted diseases
  • Past history of similar symptoms or STDs in patient and current or past partners
  • Type of contraception used
  • History of sexual assault
  • Reproductive history
    • Details of parity including any history of ectopic pregnancies
    • Timing of the last menstrual period
    • Assessing the possibility of pregnancy

Symptoms

Common urogenital and extragenital Infection

  • Between 30–60% of women with gonorrhea are asymptomatic or have subclinical disease.[6]
  • 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. They may be completely unaware that they have caught the disease, and therefore do not seek treatment. This increases the risk of complications and the chances of passing the infection on to another person.

Common symptoms of urogenital and extragenital gonococcal Infection may include the following:[1][2][3][4][7][8]

Type of Gonococcal Infection Symptoms Images[9][10]
Male Genitourinary
  • Thick, copious, white, yellow, or green colored discharge from penis
  • Burning and pain while urinating
  • Urinary frequency or urgency
  • Painful or swollen testicles
  • scrotal pain or swelling
  • Decreased or abnormal urine stream may suggest stricture
Female Genitourinary
Gonococcal proctitis (Rectal)
  • Often asymptomatic
  • Anal discharge
  • Pain on defecating
  • Rectal bleeding
  • Pruritus
  • Tenesmus
  • Bloody diarrhea
Gonococcal pharyngitis
  • Usually asymptomatic
  • Mild to sever sore throat
Ophthalmia neonatorum
  • Occurs within 2-5 days after birth
  • Severe white bilateral discharge
  • Tearing
  • Eyelids swellings

Disseminated gonococcal infection

Symptoms of disseminated gonorrheal infection may include the following:[11][12][5]

Type of Disseminated gonorrheal infection Symptoms Images[10][13]
Arthritis Dermatitis Syndrome
  • Asymptomatic genitourinary
  • Joint or tendon pain
  • Rash commonly found below neck, palm and sole
  • Fever
Septic arthritis
  • Abrupt onset of arthritis (Knees, wrists, and ankles)
  • Without skin lesion
Gonorrhea Meningitis
  • As a rare complications of DGI
  • Headache
  • Neck pain and stiffness
  • Fever
  • Decreased sensorium may indicate gonococcal meningitis
Gonorrhea Endocarditis
  • As a rare complications of DGI
  • Very rarely it may settle in the heart causing endocarditis
  • Fever and chills
  • Malaise
  • Atypical chest pain

References

  1. ↑ 1.0 1.1 1.2 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.
  2. ↑ 2.0 2.1 2.2 Sherrard J, Barlow D (1996). "Gonorrhoea in men: clinical and diagnostic aspects". Genitourin Med. 72 (6): 422–6. PMC 1195730. PMID 9038638.
  3. ↑ 3.0 3.1 3.2 Barlow D, Phillips I (1978). "Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects". Lancet. 1 (8067): 761–4. PMID 76760.
  4. ↑ 4.0 4.1 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.
  5. ↑ 5.0 5.1 Rice PA (2005). "Gonococcal arthritis (disseminated gonococcal infection)". Infect Dis Clin North Am. 19 (4): 853–61. doi:10.1016/j.idc.2005.07.003. PMID 16297736.
  6. ↑ van Duynhoven YT (1999). "The epidemiology of Neisseria gonorrhoeae in Europe". Microbes Infect. 1 (6): 455–64. PMID 10602678.
  7. ↑ Stansfield VA (1980). "Diagnosis and management of anorectal gonorrhoea in women". Br J Vener Dis. 56 (5): 319–21. PMC 1045815. PMID 7427703.
  8. ↑ Kraus SJ (1Link title979). "Incidence and therapy of gonococcal pharyngitis". Sex Transm Dis. 6 (2 Suppl): 143–7. PMID 386537. Check date values in: |year= (help)
  9. ↑ STD Gonorrhea Infection Gallery http://www.std-gov.org/std_picture/gonorrhea_w.htm Accessed on September 22, 2016
  10. ↑ 10.0 10.1 Centers for Disease Control and Prevention. Public Health Image Library (PHIL) http://phil.cdc.gov/phil/details.asp Accessed on September 22, 2016
  11. ↑ Bleich AT, Sheffield JS, Wendel GD, Sigman A, Cunningham FG (2012). "Disseminated gonococcal infection in women". Obstet Gynecol. 119 (3): 597–602. doi:10.1097/AOG.0b013e318244eda9. PMID 22353959.
  12. ↑ O'Brien JP, Goldenberg DL, Rice PA (1983). "Disseminated gonococcal infection: a prospective analysis of 49 patients and a review of pathophysiology and immune mechanisms". Medicine (Baltimore). 62 (6): 395–406. PMID 6415361.
  13. ↑ STD Gonorrhea Infection Gallery http://www.std-gov.org/std_picture/gonorrhea_w.htm Accessed on September 22, 2016


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