Gonorrhea Neisseria gonorrhoeae, "The Clap"

• Facts:
  Common sexually transmitted infection caused by gram negative intracellular diplococcus
• History / PE:
  Women
  Greenish-yellow discharge
  Pelvic/adnexal pain
  Swollen Bartholin's glands
  
  Men
  Purulent urethral discharge
  Dysuria
  Erythema of urethral meatus
  
  Disseminated disease
  Monoarticular septic arthritis
  Rash
  Tenosynovitis
• Diagnosis:
  Gram stain and culture
  Nucleic acid amplification tests
• Treatment:
  Ceftriaxone IM or cefepime PO X 1 dose
  Treat for possible chlamydia coinfection (doxycycline X 7 days or macrolide X 1 dose)
  
  IV ceftriaxone for atleast 24hrs (disseminated disease)
• Complications:
  Infertility
  Tubo-ovarian abscess with rupture
  Disseminated gonococcal infection
• Differential Diagnosis:
  Chlamydia urethritis (mucopurulent, absent bacteriuria)