Gonorrhea Also called the clap Caused by Neisseria gonorrhoeae, also known as gonococcus or GC It occurs mostly in young adults

(15 to 25 years old) In United States, 650, 000 new cases have been reported every year Increasing rates among homosexual men Gonococcus is pyogenic (pus forming) Gram negative diplococci that evokes inflammatory reaction characterized by purulent exudates Humans are the only natural host Organism grows best in warm, mucus secreting epithelia Portal of entry: Genitourinary tract Eyes Oropharynx Anorectum Skin Heterosexual/homosexual intercourse Autoinoculation to the conjunctiva is possible Gonorrheal Conjunctivitis Neonates born to infected mothers can acquire the infection during passage through birth canal Blindness Incubation period is 2 to 7 days after exposure Infected women may be asymptomatic for weeks or months, during which time sever damage to the reproductive system may occur Begins in: Anterior urethra Accessory urethral glands Bartholins/Skenes glands Cervix If untreated, gonorrhea spreads from its initial sites upward into the genital tract In males: spreads to the prostate and epididymis In females: moves to fallopian tubes Disseminated Gonococcal Infection Can also invade bloodstream Serious sequelae (aftereffect of disease) such as bacteremic involvement of joint spaces, heart valves, meninges, and other body organs and tissues Men are most likely to be symptomatic (with symptoms) than women Symptoms in men: Urethral pain Creamy, yellow, sometimes bloody discharge Chronic disease

It affects: Prostate Epididymis Periurethral glands Experience also rectal infections Symptoms in women: Unusual genital/urinary discharge Dysuria (difficult/painful discharge) Dyspareunia Pelvic pain/tenderness Fever Proctitis Symptoms increasing during/immediately after menstruation because the bacterium is an intracellular diplococcus that thrives in menstrual blood but cannot survive long outside the human body Salpingitis Inflammation of fallopian tubes Diagnosis: Gram stain for symptomatic men (meaning with symptoms) typical appearance of Gram stained urethral discharge from male patients, with numerous white blood cells and numerous intra and extracellular Gram negative diplococci. Culture for women and asymptomatic men (because for infected people without symptoms, gram stain is often unreliable) on chocolate agar or a modified chocolate agar (such as Thayer Martin medium, Martin Lewis medium, New York City agar) From appropriate site: Endocervix Urethra Anal canal Oropharynx Grows in carbon dioxide environment This organism is fastidious, so it should have the ff: Specific nutrient and environmental needs pH of 7.4 Temperature at 35.5 C Atmosphere containing 2% - 100% carbon dioxide Treatment recommendation: Ceftriaxone in single injection Cefixime in single oral dose

Ciprofloxacin in single oral dose Ofloxacin in single oral dose