What is this Condition?

A common venereal disease that affects both sexes, gonorrhea is an infection of the genitourinary tract (especially the urethra and cervix and, occasionally, the rectum, pharynx, and eyes. Untreated gonorrhea can spread through the blood to the joints, tendons, membrane, of the spinal cord and brain, and the interior membrane lining of the heart; in women, it can also lead to chronic pelvic inflammatory disease and sterility.

After adequate treatment, the prognosis for both men and women is excellent, although reinfection is common. Gonorrhea is especially prevalent among young people (between ages 19 and 25) and people with multiple sexual partners.

What Causes it?

Transmission of Neisseria gonorrhoeae, the organism that causes gonorrhea, almost always follows sexual contact with an infected person. Children born of infected mothers can contract neonatal gonococcal conjunctivitis as they pass through the birth canal. Children and adults with gonorrhea can get this type of conjunctivitis by touching their eyes with contaminated hands.

What are its Symptoms?

Although many infected men may have no symptoms, after 3 to 6 days, some develop symptoms of urethritis, including painful urination and a pus-filled urethral discharge, with redness and swelling at the infection site. Most infected women remain symptom-free, but some develop inflammation and a greenish yellow discharge from the cervix - the most common gonorrheal symptoms in women. Other signs and symptoms vary according to the infection site.

Signs of neonatal conjunctivitis include swollen eyelids, conjunctival infection in both eyes, and a heavy pus-filled discharge 2 to 3 days after birth. Adult conjunctivitis, most common in men, causes conjunctival redness and swelling in one eye. Untreated gonococcal conjunctivitis can progress to blindness.

How is it Diagnosed?

A culture from the infected body part usually establishes the diagnosis by isolating the organism. A lab test called a Gram stain supports the diagnosis and may be sufficient to confirm gonorrhea in men. A culture of scrapings from the eye confirms gonococcal conjunctivitis.

How is it Treated?

For adults and adolescents, the recommended treatment for uncomplicated gonorrhea caused by N gonorrhoeae is Rocephin by intramuscular injection. Treatment of concurrent chlamydial infection may require Vibramycin taken orally. A single dose of Race ph in followed by E-Mycin for 7 days is recommended for pregnant women and those allergic to penicillin. Other drugs may be used to treat complications.

Drug therapy should be continued for 24 to 48 hours after improvement begins; usually a full week of antibiotics is required, although the doctor may switch to different medications to finish treatment.

Routine instillation of 1 % silver nitrate or llotycin drops into the eyes of newborns has greatly reduced the incidence of gonococcal neonatal conjunctivitis.