Gonorrhoea

Question 1

What kind of bacteria is neisseria gonorrhoeae?

Answer 1

Gram-negative diplococcus

Question 2

This bacteria infects mucous membranes with a columnar epithelium - name 2 areas that are susceptible

Answer 2

• Endocervix
• Urethra
• Rectum
• Conjunctiva
• Pharynx

Question 3

1) Name 2 ways infection in women can present
2) Name 2 ways infections in men can present

Answer 3

1) Odourless purulent discharge that may be green or yellow, dysuria, pelvic pain
2) Odourless purulent discharge that may be green or yellow, dysuria, testicular pain or swelling (epididymo-orchitis)

Question 4

1) What is the diagnostic test that tests for the presence of gonorrhoea?
2) Why is a standard charcoal endocervical swab important?

Answer 4

1) Nucleic acid amplification testing
2) It’s taken for microscopy, culture and antibiotic sensitivities to guide antibiotic treatment

Question 5

How is gonorrhoea managed if the sensitivities are NOT known?

Answer 5

Single dose of intramuscular ceftriaxone 1g

Question 6

How is gonorrhoea managed if the sensitivities ARE known?

Answer 6

A single dose of oral ciprofloxacin 500mg

Question 7

Name 3 complications of gonorrhoea

Answer 7

• Pelvic inflammatory disease
• Chronic pelvic pain
• Infertility
• Epididymo-orchitis
• Prostatitis
• Conjunctivitis
• Urethral strictures
• Disseminated gonococcal infection
• Skin lesions
• Septic arthritis
• Endocarditis

Question 8

1) Gonococcal infection can be contracted from the mother during birth - what is neonatal conjunctivitis called?
2) This is a medical emergency characterised by what 3 features?

Answer 8

1) Ophthalmia neonatorum
2) Sepsis, blindness, perforation of the eye

Question 9

How do you manage gonorrhoea if a patient is needlephobic?

Answer 9

oral cefixime and azithromycin