Gonorrhea (the clap) is a bacterial infection caused by Neisseria gonorrhoeae. It affects the mucous membranes of the genitals, rectum, throat, and eyes. Left untreated, it can lead to severe complications, including infertility.
Contents
1. Etiology (Cause)
- Pathogen: Neisseria gonorrhoeae (gram-negative diplococcus).
- Resistance:
- Dies when dried, heated, or exposed to antiseptics.
- Increasingly resistant to antibiotics (especially penicillins, fluoroquinolones).
2. Transmission
- Sexual (95% of cases):
- Vaginal, anal, oral sex.
- Contact with infected secretions.
- Vertical (mother to child):
- During childbirth → gonococcal conjunctivitis in newborns.
- Rarely:
- Shared towels/underwear (only if contaminated with fresh discharge).
3. Symptoms
Incubation period: 2–7 days (up to 2 weeks in some cases).
In Men:
- Burning during urination.
- Yellow-green pus-like discharge from the urethra.
- Redness/swelling of the penis tip.
- Testicular pain (if epididymis is infected).
In Women:
- 50% are asymptomatic.
- Vaginal discharge (pus-like).
- Pain during urination/sex.
- Irregular bleeding.
Other Forms:
- Rectal (after anal sex): Itching, anal discharge.
- Pharyngeal (after oral sex): Rarely symptomatic (possible sore throat).
- Conjunctivitis: Pus-filled eye inflammation.
4. Diagnosis
- Microscopy (discharge smear) – fast but ~70% accurate.
- PCR (urethral/vaginal/throat swab) – most reliable.
- Culture (antibiotic sensitivity testing).
- Urine test (for men).
Key point: Get tested even without symptoms!
5. Treatment
WHO Guidelines (2021):
- First-line:
- Ceftriaxone (500 mg IM, single dose) + Azithromycin (1 g oral).
- Alternative:
- Cefixime (400 mg oral) + Azithromycin (1 g).
Important:
- Both partners must be treated!
- No sex for 7 days post-treatment.
- Retest after 2 weeks.
6. Prevention
- Condoms (90% risk reduction).
- Regular screening (every 6–12 months with new partners).
- Never self-treat (promotes antibiotic resistance).
7. Emergency Post-Exposure Steps
After unprotected sex with an infected person:
- Within 2 hours:
- Rinse genitals with Miramistin or chlorhexidine.
- After 3–5 days:
- Get a PCR test.
- Emergency prophylaxis:
- Single-dose Cefixime 400 mg (doctor’s prescription only!).
8. How to Spot Gonorrhea in Others
Tell-tale signs:
- Men: Pus discharge + painful urination.
- Women: Heavy yellow discharge + pelvic discomfort.
But:
- 50% of women and 10% of men show no symptoms!
- Only a lab test confirms diagnosis.
9. Complications
- Men:
- Epididymitis → infertility.
- Urethral stricture (narrowing).
- Women:
- Pelvic inflammatory disease → infertility/ectopic pregnancy.
- Reactive arthritis (joint pain, eye inflammation).
Key Takeaway
Gonorrhea is a stealthy infection that can cause irreversible damage. Treat it immediately upon suspicion. At the first sign, get a PCR test and see a doctor (dermatovenereologist, urologist, gynecologist).
Note: No immunity post-recovery – reinfection is possible!
