Gonorrhoea Flashcards
What bacteria is gonorrhoea caused by?
Neisseria gonorrhoeae
What type of bacteria is neisseria gonorrhoeae?
Gram negative diplococci
What antibiotics are many strains of gonorrhoea now resistant to?
Azithromycin and ciprofloxacin
What is the presentation of gonorrheoa infection?
Female:
- Odourless purulent discharge - green or yellow
- Dysuria
- Pelvic pain
Male:
- Dysuria
- Odourless purulent discharge - green or yellow
- Testicular pain
Women more likely to be asymptomatic
What are the risk factors for gonorrhoea infection?
Age 15-24
Black ancestry
Current/prior history of STI
Multiple recent sexual partners
Inconsistent condom use
MSM
Partner with risk factors
History of sexual or physical abuse
What are the differentials of gonorrhoea?
Chlamydia
Trichomonas
Mycoplasma
PID
Candidiasis
UTI
What is the first line investigation for diagnosis of gonorrhoea?
NAAT testing
Standard charcoal swab for microscopy, culture and sensitivity
What type of swabs can be used for NAAT diagnosis of gonorrhoea?
Endocervical
Urethral
Vulvovaginal
Rectal
Pharyngeal
How else can gonorrhoea be diagnosed?
First catch urine
What is the first line management of gonorrhoea?
1g IM ceftriaxone
What follow up does the patient require after gonorrhoea infection?
The patient needs follow up ‘test of cure’
- After 72 for culture
- After 7 days for DNA NAAT
- After 14 days for RNA NAAT
What are the complications of gonorrhoea?
PID
Chronic pelvic pain
Infertility
Conjunctivitis
Epididymo-orchitis
Disseminated gonorrheal infection
Urethral stricture
What does disseminated gonorrheal infection cause?
Non-specific skin lesions
Polyarthralgia
Migratory polyarthritis
Systemic systems - fever and fatigue
What is the key complication of gonorrhoea in a neonate?
Neonatal conjunctivitis - opthalmia neonatorum
