6. Gonorrhoea

Question 1

what is gonorrhoea a member of?

Answer 1

the Neisseriaceae family

Question 2

what type of bacteria is gonorrhoea?

Answer 2

gram-negative diplococci

Question 3

where does gonorrhoea grow?

Answer 3

only on enriched media e.g. chocolate agar

Question 4

where does gonococcus primarily infect in females?

Answer 4

the cervix and urethra

Question 5

what can gonococcus infections in females lead to?

Answer 5

acute cervicitis with vaginal discharge and ‘urethra syndrome’ where the urethra is infected

Question 6

what are the complications of gonococcus infections in females?

Answer 6

PID: occasionally with tubo-ovarian abscess
Bartholins abscess
Disseminated gonococcal infection

Question 7

what is Disseminated gonococcal infection?

Answer 7

a rare complication that affects women more than men

Question 8

what are the common symptoms of Disseminated gonococcal infection?

Answer 8

pain on the joints
tenosynovitis
rash

Question 9

what is tenosynovitis?

Answer 9

inflammation and swelling of a tendon

Question 10

what does gonococcal infection in males cause?

Answer 10

gonococal urethritis

Question 11

complications of gonococcal infection in males?

Answer 11

epididymitis

disseminated gonococcal infection

Question 12

diagnosis of Neisseria gonorrhoea?

Answer 12

a fragile organism and doesn’t survive transportation well

Question 13

how should specimens be taken for sampling gonorrhoea?

Answer 13

specimens should be taken and plated directly onto media at the bedside (as occurs in GUM clinics)

Question 14

how do you collect specimens for gonorrhoea in females?

Answer 14

endocervical swab
urethral swab
rectal swab
pharyngeal swab

Question 15

how do you collect specimens for gonorrhoea in males?

Answer 15

urethral, rectal, pharyngeal swabs

Question 16

what is the lab diagnosis carried out for gonorrhoea?

Answer 16

gram stain

the characteristic appearance of gram-negative diplococci allows a presumptive diagnosis to be made (in some patients)

Question 17

why is a culture for gonococcal infection needed?

Answer 17

far more sensitive than microscopy

Question 18

how should organisms that resemble Neisseria on culture be confirmed as Neisseria gonorrhoeae?

Answer 18

on the basis of biochemical tests in order to distinguish them from other species

Question 19

why is sensitivity testing important?

Answer 19

as antibiotic resistance patterns are valuable in guiding future management guildlines

Question 20

treatment for Neisseria gonorrhoeae?

Answer 20

N. gonorrhoeae may vary in sensitivity

initial therapy usually guided by severity of symptoms and local knowledge of sensitivity patterns

Question 21

what is common in treatment for Neisseria gonorrhoeae?

Answer 21

penicillin resistance