Source: Knodel LC, Duhon B, Argamany J. Sexually transmitted diseases. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146072585. Accessed March 8, 2017.
Gonococci attach to mucosal cell membranes via surface pili.
Mucosal damage leads to tissue invasion by polymorphonuclear leukocytes followed by formation of submucosal abscesses and secretion of purulent exudates.
Difficult to control due to rapid incubation period and large numbers of asymptomatic individuals.
Sexually transmitted infection (STI)
Half of STIs occur in persons in teens and twenties.
Number of reported cases in the United States stable over past 10 years.
Most common clinical features of gonococcal infections presented in Table 1
Gonococci invade bloodstream in 0.5–3% of patients and produce disseminated disease.
Clinical manifestations of disseminated gonococcal infection:
TABLE 1.Presentation of Gonorrhea Infections ||Download (.pdf) TABLE 1. Presentation of Gonorrhea Infections
| ||Men ||Women |
|General ||Incubation period 1–14 days ||Incubation period 1–14 days |
| ||Symptom onset in 2–8 days ||Symptom onset in 10 days |
|Site of infection ||Most common—urethra ||Most common—endocervical canal |
| ||Others—rectum (usually due to rectal intercourse in men who have sex with men), oropharynx, eye ||Others—urethra, rectum (usually due to perineal contamination), oropharynx, eye |
|Symptoms ||Commonly symptomatic, may be asymptomatic ||May be asymptomatic or minimally symptomatic |
| ||Urethral infection—dysuria and urinary frequency ||Endocervical infection—usually asymptomatic or mildly symptomatic |
| ||Anorectal infection—asymptomatic to severe rectal pain ||Urethral infection—dysuria, urinary frequency |
| ||Pharyngeal infection asymptomatic to mild pharyngitis ||Anorectal and pharyngeal infection—symptoms same as for men |
|Signs ||Purulent urethral or rectal discharge can be scant to profuse ||Abnormal vaginal discharge or uterine bleeding; purulent urethral or rectal discharge can be scant to profuse |
| ||Anorectal—pruritus, mucopurulent discharge, bleeding || |
|Complications ||Rare (epididymitis, prostatitis, inguinal lymphadenopathy, urethral stricture) ||Pelvic inflammatory disease and ...|