6.3.1. Infections of the Genital Tract - Gonorrhoea

Question 1

What is the Cause of Gonorrhoea?

Answer 1

Neisseria Gonorrhoeae

Question 2

What are the Symptoms of Gonorrhoea in Men?

Answer 2

1. Asymptomatic - 10% (May have Signs if Examined)
2. Thick, Profuse, Yellow Discharge
3. Dysuria
   Note - Rectal / Pharyngeal Infections are Often Aymptomatic

Question 3

What are the Symptoms of Gonorrhoea in Women?

Answer 3

1. Asymptomatic - > 50%
2. Vaginal Discharge
3. Dysuria
4. Intermenstrual / Post-Coital Bleeding

Question 4

What are the Complications of Gonorrhoea in Men?

Answer 4

1. Epididymitis
2. Acute Monoarthritis (usually Elbow / Shoulder) - Very Rare
3. Gonococcal Infection - Skin Lesion (Pustular with a Halo) - Very Rare

Question 5

What are the Complications of Gonorrhoea in Women?

Answer 5

1. Pelvic Inflammatory Disease
2. Bartholin’s Abscess (Gonococcal Opthalmia Neonatorum)
3. Acute Monoarthritis (usually Elbow / Shoulder) - Very Rare
4. Gonococcal Infection - Skin Lesion (Pustular with a Halo) - Very Rare

Question 6

What is the Incubation Period of Gonorrhoea?

Answer 6

1. Average is 5-6 days

2. Range is 2 days - 2 weeks (if they get symptoms at all)

Question 7

What is the Epidemiology of Gonorrhoea in Grampian?

Answer 7

150 cases / year
Most cases are in Men, often MSM
Note - This is much less common than Chlamydia

Question 8

How is Gonorrhoea Diagnosed?

Answer 8

1. Nucleic Acid Amplification Test (NAAT) on Urine / Swab - Can be Self / Clinically Obtained
2. Gram Stained Smear from the Urethra / Cervix / Rectum (in Symptomatic People)
3. Culture of Swab-Obtained Specimen

Question 9

What is the treatment of Gonorrhoea?

Answer 9

Blind treatment with:
1. I.M. Injection of Ceftriaxone (500mg)
2. Azithromycin (1g)
Note - Can also treat according to Antibiotic Sensitivities

Question 10

When should a Follow-Up, after a Gonorrhoea Treatment has taken place, be?

Answer 10

1. Test of Cure at 2 Weeks

2. Test of Re-Infection at 3 months