Gonorrhea physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Physical examination

Type of Disseminated gonorrheal infection	Symptoms
Female genitourinary	Mucopurulent uretral, cervical or vaginal discharge Positive cervical motion tenderness Friable cervical mucosa Abdominal pain with negative rebound tenderness Lower abdominal pain (consistent with PID) Right upper quadrant pain (Fitz-Hugh-Curtis syndrome) Labial edema and Bartholin’s gland enlargement and tenderness (Bartholinitis)
Male genitourinary	Mucopurulent urethral discharge Penile edema Unilateral epididymal tenderness and edema epididymitis Urethral stricture - Uncommon; more often seen in the preantibiotic era with urethral irrigation using caustic liquids
Gonorrhea Meningitis	As a rare complications of DGI Settle in the spinal column (both are more likely among individuals with immunosuppression Headache, neck pain and stiffness, fever, and decreased sensorium may indicate gonococcal meningitis
Gonorrhea Endocarditis	As a rare complications of DGI Very rarely it may settle in the heart causing endocarditis Endocarditis may present as fever, chills,malaise, atypical chest pain as well as typical features of disseminated infections More common in men compared to women Severe damage to valve may occur

Male

• Purulent or mucopurulent discharge from urethera. The discharge can be demonstrated by milking the shaft of penis.
• Epididymal tenderness and edema usually unilateral

Female Pelvic examination

Inspection

• Purulent or mucopurulent discharge
• Vaginal bleeding

Palpation

• Cervical mucosa may become fragile and bleed even with some manipulation.
• Cervical motion tenderness during bimanual pelvic examination

Gallery

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  A highly contagious infection, gonococcal ophthalmia is due the pathogenic bacteria Neisseria gonorrhoeae. From Public Health Image Library (PHIL).

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  This patient presented with gonococcal urethritis, which became systemically disseminated leading to gonococcal conjunctivitis of the right eye. From Public Health Image Library (PHIL).

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  Photograph of a gonococcal infection involving the cervix of a patient who presented with a case of gonorrhea. From Public Health Image Library (PHIL).