Gonorrhea

Question 1

Describe gonorrhea.

Answer 1

An STD producing purulent inflammation of mucous membranes.

Question 2

Is gonorrhea reportable?

Answer 2

Yes

Question 3

Which groups are at high risk for gonorrhea? Low risk?

Answer 3

High risk:
- Men who have sex with men
- IV drug users
- Other high risk behaviors

Low risk (uncommon among):
- monogamous, heterosexual populations

Gonorrhea is under-diagnosed in the US

Question 4

Describe assessment findings for males with gonorrhea.

Answer 4

• Purulent urethral discharge
• Dysuria
• Testicular pain
• Possibly asymptomatic

Question 5

Describe assessment findings for females with gonorrhea.

Answer 5

• Often asymptomatic
• Endocervical discharge
• Dysuria
• Bartholin glands abscess
• Abnormal vaginal bleeding
• Adnexal tenderness
• Cervical motion tenderness (chandelier test)

Question 6

What tests could/should be done for gonorrhea?

Answer 6

• Gram stain of exudate
• DNA probe
• NAAT (Nucleic Acid Amplification Test)
• Culture of exudate or joint aspirate on Thayer-Martin/chocolate agar

Question 7

What is the pharmaceutical treatment for gonorrhea?

Answer 7

Primary:
- Ceftriaxone 250 mg IM x 1
–AND–
- Azithromycin 1 g PO x 1

Secondary (less effective):
- Cefixime 400 mg PO x 1
–AND–
- Azithromycin 1 g PO x 1

If Azithromycin allergy:
- Doxycycline 100 mg PO BID x 7 days
–AND–
- Test for cure in 7 days