Gonorrhea Overview

Gonorrhea is a sexually transmitted disease that can be treated, caused by a bacterium called Neisseria Gonorrhea. This bacterium can infect the genital tract, mouth, and rectum. In women, access through the uterus is the first place where the infection debuts. However, the disease can spread into the uterus and the fallopian tubes causing an inflamed pelvis (IP). This disease affects over 1 million women in the United States and can cause infertility in over 10% of the cases. In 1997, health professionals reported 324,901 cases of gonorrhea in the United States alone. The Institute of Medicine estimated, however, that over 800,000 cases of gonorrhea occur annually in the United States, cases that lead to spending more than $ 1 billion on the treatment of this disease and on its complications. In 2011, over 321,849 cases of gonorrhea were reported at the CDC. After chlamydia, gonorrhea is the most common sexually transmitted disease infecting more than 106 million people each year. Infection may be present even in the apparent absence of symptoms. However, the infection can still be transmitted until it is treated and completely cured.

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Gonorrhea is transmitted during sexual intercourse (whether it is vaginal, oral or anal). People who practice anal sex can contract gonorrhea of the rectum. Even women who do not take part in anal intercourse can become infected if the bacteria has spread to the vaginal region. Infected women can pass on gonorrhea to their newborns during childbirth, causing eye infections in their children. However, this complication is somewhat rare because newborn babies receive a treatment to prevent this infection. If infection occurs in the genital tract, mouth or rectum of a child, it is usually due to sexual abuse. Any child with chlamydiosis requires a consultation done by a senior medical specialist to determine the exact cause of the ailment, and also to investigate a possible sexual abuse.

Gonorrhea Symptoms

The first symptoms are usually discrete. These occur over a period of two to ten days after sexual intercourse with an infected partner. Often no symptoms show in people already infected with gonorrhea, so 10 to 15% of men and up to 80% of women do not show any symptoms at all. These individuals are the most likely to develop complications of gonorrhea and spread the disease unknowingly and unwillingly.

The first symptoms that occur in women are:

  • Bleeding associated with sexual intercourse
  • A disturbing or painful sensation during urination
  • Yellow or bloody vaginal discharges

Other, more advanced symptoms that indicate the development of pelvic inflammation, include cramps and pain, bleeding between menstrual periods, vomiting and fever.

Men have symptoms more often than women. These include:

  • The appearance of pus inside the penis
  • A burning sensation during urination that may be quite severe.

Symptoms of rectal infection include itching in the anal area and bleeding during defecation.

Gonorrhea Treatment

Usually only a single dose of antibiotics is prescribed to treat gonorrhea, such as:

  • Ceftriaxone
  • Cefixime
  • Ciprofloxacin
  • Ofloxacin

For infected pregnant women or young people up to 18 years old, it is not recommended to use ciprofloxacin or Ofloxacin. The choice remains the doctor’s, who can prescribe the best and safest option for a specific case. Gonococcal infection is usually accompanied by other sexually transmitted diseases. Therefore, doctors prescribe a combination of antibiotics, such as ceftriaxone and doxycycline or azithromycin, which will treat both diseases at the same time. Complications that can occur in the absence of treatment: In the event the disease remains untreated, the bacteria will spread to the entire genital tract, or in some of the cases, it, through blood dissemination, can affect the joints, the heart’s valve system or the central nervous system. The most common result of untreated gonorrhea is pelvic inflammatory disease (PID), a serious infection of the female reproductive organs. Gonococcal PID often appears immediately after the end of the menstrual period. IP can cause scarring in the fallopian tubes. If the tube is partially scarred, the fertilized egg cannot reach the uterus. If this happens, the embryo may implant in the tube causing an extra uterine pregnancy. This serious complication can cause a miscarriage and can lead to maternal death. For those affected by gonococcal infection, they have an increased risk of HIV infection, so it is important to prevent or treat it in the early stages of the disease.

Gonorrhea and infants:

Pregnant women infected with gonorrhea can transmit the infection during childbirth. The doctor can prevent the eye infection by administering silver nitrate or other medications immediately after birth. Due to the high risk of infection, pregnant women are recommended at least one gonorrhea testing during pregnancy.

Prevention of gonorrhea:

To reduce the risk of gonococcal infection it is necessary to use condoms correctly during normal or anal sexual acts.

Research field:

Researchers supported by the National Institute of Allergy and Infectious Diseases (NIAID) continue to study the bacteria that causes gonorrhea and are working on better methods of prevention, diagnosis and treatment of this disease. A very important issue puts the emergence of drug-resistant gonococcal bacteria, which highlights the need for more effective methods of prevention, such as a vaccine. So far they have developed techniques for detecting drug-resistant bacteria groups, techniques to help physicians in choosing appropriate treatment, but a general vaccine has yet to be produced. Soon, gonorrhea will be a disease that will no longer be treated as it already has become resistant to many types of treatment, according to the World Health Organization warnings. Every year, more than 106 million new cases appear, demonstrated by statistics institutions. A report published last year shows that in Japan, in 2008, the disease could not be treated with any antibiotic used previously, informs Reuters, quoted by International Business Times. “If it was a local phenomenon, not too many years will pass before it becomes a global one!” cautions Dr. Manjula Lusti-Narasimhan, of the WHO. Already fears have come true in countries such as Australia, France, Norway, Sweden and the UK, as some sexually transmitted disease can no longer be treated with current antibiotic classes.

Gonorrhea Testing

Physicians and other health care professionals usually use three methods of diagnosing gonorrhea: biological samples from the infected area and staining, detection of bacterial genes in urine and bacteria growth in laboratory cultures. Many doctors prefer to use several tests to increase the accuracy of the diagnosis. Gram staining. This test can be performed right in the doctor’s office or clinic immediately. A sample from the urethra or cervix lies on a slide and gets stained. The doctor can directly view such a bacteria under the microscope even when consultation. The staining method involves placing a small amount of penile and cervical secretions on a slide and mixed with a dye. Then the doctor looks for the bacteria on the slide using a microscope. This test takes very little. This method is very good for diagnosing men, but is not effective in women. Only one woman out of two infected with gonorrhea will show an identifiable trace. Most often, doctors use urine and cervical secretions to detect bacterial genes. These tests give even better results than culturing the bacteria, so are widespread. Culture tests involve placing a sample of the secretion in culture medium and incubating it for up to two days to allow the bacteria to grow and multiply. The sensitivity of this test depends on the area from which the sample is taken. Cultures of cervical samples detect infection in about 90 percent of the cases. Samples from the throat can also be used to diagnose throat gonorrhea. Crops are also used to determine the drug resistance of the bacteria. Note: Prevention of a sexually transmitted disease is much easier than treating it.

References

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