Gonorrhoae

Question 1

What is gonorhoae (aetiology, RF)

Answer 1

Neissseria Gonnorrhoae -gram -ve diplococci
2nd most common STI (after chlamydia)

RF- Unprotected sex, multiple partner, other STI, HIV, age <25, MSM

Question 2

Sx and Ix of Gonorrhoeae

Answer 2

asympto in 50%
Pv discharge, IMB, PCB, dysuria, dyspareunia, lower abdo pain (nearly identical to chalmydia)
conjunctivitis/pink eye

speculum - mucopurulent discharge and easy to induce bleeds
Bimanual for PID

Ix - empirical only if recent contact with known gonnorrhaoe person
direct micro -see gram -ve diplocci and epithelial cells -give Abx
1st - NAAT from first catch urine (men) or vulvovaginal (women) - takes 5 days then abx
2nd - culture ans sensitivities - abx

Question 3

Mx and complications of Gonorrheoa

Answer 3

after confirm by NAAT, cultures or micro–
1st line ceftriaxone 1g IM

screening other STI, avoid sex 1 week, contact trace, follow up after 1 week (95% cure)

complication-
PID, infertility, ectopic, conjuctivitis
Fitz hgh curtiz syndrome (perihepatitis)- PID with adhesion to liver

increase HIV susceptibility

disseminated disease rarely

vertical transmission-opthalmia neonatorum-bilateral conjunctivitis