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)



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July 24th 2010