Gonorrhoea

Question 1

What type of organism is neisseria gonorrhoeae

Answer 1

Gram negative intracellular diplococcus

Question 2

What is the clinical presentation for gonorrhoea in males?

Answer 2

Urethritis is the main symptomPlus epididymitis, prostatitis, proctitis and pharyngitis

Question 3

What is the clinical presentation for gonorrhoea in females?

Answer 3

Usually asymptomatic– endocervicitis, urethritis and PID

Question 4

Describe gonorrhoea in females

Answer 4

Mainly infects the cervix and urethraCan lead to acute cervicitis with vaginal discharge and urethral syndrome (frequency and dysuria)

Question 5

What is a significant but rare complication of gonorrhoea in females?

Answer 5

Disseminated gonococcal infectionAffects women more than men

Question 6

How is gonorrhoea diagnosed?

Answer 6

Swab and CultureMale – urethral, rectal adn pharyngeal swabFemales – endocervical, urethral, rectal and pharyngeal swab

Question 7

Give some features of testing for neisseria gonorrhoeae

Answer 7

Can only grow on chocolate agarDoes not survive transport well so must be transferred to plate at bedsideIf you see a characteristic gram neg. diplococci you can make a presumptive diagnosisCulture is much more sensitive than microscopy

Question 8

What it the treatment for gonorrhoea?

Answer 8

Intramuscular ceftriaxone– used to use ciprofloxacin but resistance was developed– treatment is guided by the severity of symptoms and local knowledge of sensitive agents