Clinical Manifestations of Gonorrhoea

Gonorrhoea is the oldest known venereal disease, which is caused by Neisseria gonorrhoeae. It is a very common cause of urethral discharge in men and cervitis (inflammation of the cervix) in women. Other areas affected may be rectum and pharynx. Infants may also acquire the infection in the eyes at the time of birth (ophthalmia neonatarum).

The affected site may be anywhere in the female reproductive tract including urethra, vagina, cervix, ovaries, fallopian tubes or anus. However, the infection tends to be limited at the urethra in men. Transmission is more common from male to female (75%) than vice versa (25%).

The infection is more commonly seen in women between menarche (onset of menses) and menopause (cessation of menses). Though, the infection may present asymptomatically also.

Clinically, the female presents with greenish-yellow discharge from the vagina along with dysuria (pain while urination), vulvitis, cystitis vaginitis or pain in the pelvis. Women suffering from chronic disease often complain of backache, dull abdominal pain, menstrual irregularities and dyspareunia (painful coition).

In males, the picture presents as purulent urethral discharge with dysuria and redness of the urethral opening.

Diagnosis is confirmed by the smear of the discharge and culture of the organism on a specific medium.

Treatment aims at limiting the growth of the organism. Earlier, penicillin was used extensively. But with rising resistance, other broad-spectrum antibiotics are prescribed. Besides administration of antibiotics, drainage of pus or abscess is also necessary for total cure.

Prevention of acquiring the infection can be successful through the use of condoms during the sexual encounters. Contact point of infection should be traced to prevent re-infection.

Untreated cases may complicate the case and affect the epididymis and prostate in men and can cause pelvic inflammatory disease (PID), salphingitis, perihepatitis, meningitis, pericarditis, septicaemia or polyarthritis in women. Persistent infection with pain and abscess may also lead to infertility.