Sexually transmitted infection – gonorrhea. Literature review

Greta Reikertaitė1, Ilona Šakuro1

1 Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania

Abstract

Gonorrhoea is a sexually transmitted infection caused by gram-negative gonococcus bacteria (Neisseria gonorrhoeae). Currently, it is the second most common sexually transmitted curable disease in the world right after chlamydiae infection. About 60 million new cases of gonorrhoea are diagnosed each year and the number of identified cases is constantly increasing, the disease is more prevalent among young people. The disease is contracted during any form of sexual intercourse (oral, anal or vaginal). A pregnant woman infected with gonococcus can also transmit the infection to her newborn child during childbirth, gonorrhoea can cause conjunctivitis, which, if untreated, leads to blindness. Symptoms of the disease are more common in men than in women. Symptoms of gonorrhoea can occur within a period ranging from 3 days to 14 days. Infected men experience burning, painful sensation or difficulty in urinating, purulent discharge from the urethra or rectum may occur. Redness and enlargement and tenderness of the testicles may occur, in certaing cases there may be pain in the lower abdomen. Gonorrhoea is more often asymptomatic in women, but they may sometimes experience symptoms such as increased and altered vaginal discharge, signs of blood between periods or after sexual intercourse. If left untreated, the infection rises upwards, damaging the uterus and surrounding organs in women, causing inflammatory disease of the pelvis. Untreated gonorrhoea in men and women can lead to infertility. Gonorrhoea during pregnancy may increase the risk of miscarriage or premature birth. Gonococci which spread hematologically can cause infectious arthritis or even endocarditis. In order to accurately identify this sexually transmitted disease, samples are usually taken from the urethra, the cervix. Samples are stained with Gram and/or methylene blue while gonococci are examined microscopically. The diagnosis of gonorrhoea­ is confirmed by culture or molecular testing. This sexually transmitted disease is treated with antibiotics, mainly by singles doses of ceftriaxone and azithromycin, but the increasing resistance of gonococci to antibiotics is alarming. This article reviews the clinical signs, diagnosis and treatment of gonorrhoea.

Keywords: gonorrhea, sexually transmitted disease, gonococcus.