Gonorrhoea

Overview Of Gonorrhoea

Gonorrhoea is a sexually transmitted infection (STI) caused by the bacterium *Neisseria gonorrhoeae*. It primarily affects the mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in both men and women. It can also infect the rectum, throat, and eyes. Gonorrhoea is one of the most common STIs worldwide and is highly contagious, transmitted through unprotected vaginal, anal, or oral sex. Symptoms can vary, with many individuals being asymptomatic, particularly women. When symptoms do occur, they may include discharge, dysuria (painful urination), and pelvic pain. If left untreated, gonorrhoea can lead to serious complications, including pelvic inflammatory disease (PID), infertility, and disseminated gonococcal infection (DGI). Early diagnosis and treatment are essential to prevent long-term consequences.

Causes of Gonorrhoea

• Gonorrhoea is caused by the bacterium *Neisseria gonorrhoeae*, which infects the mucous membranes of the reproductive tract, rectum, throat, or eyes. The infection is transmitted through unprotected sexual contact, including vaginal, anal, or oral sex, with an infected individual. Risk factors include having multiple sexual partners, a history of STIs, and inconsistent condom use. Young adults, particularly those under 25, are at higher risk due to increased sexual activity and potential lack of awareness about safe sex practices. Pregnant women can transmit the infection to their newborns during childbirth, leading to neonatal conjunctivitis. Asymptomatic carriers play a significant role in the spread of gonorrhoea, as they may unknowingly transmit the bacteria to sexual partners.

Risk Factors of Gonorrhoea

• Several factors increase the risk of developing gonorrhoea. Unprotected sexual activity, including vaginal, anal, or oral sex, is the primary risk factor. Having multiple sexual partners or a new sexual partner within the past two months also elevates the risk. A history of sexually transmitted infections, particularly chlamydia or gonorrhoea, increases susceptibility. Young adults, particularly those under 25, are at higher risk due to increased sexual activity and potential lack of awareness about safe sex practices. Pregnant women can transmit the infection to their newborns, leading to neonatal complications. Socioeconomic factors, such as limited access to healthcare, contribute to delayed diagnosis and treatment. Asymptomatic carriers play a significant role in the spread of gonorrhoea.

Prevention of Gonorrhoea

• Preventing gonorrhoea involves adopting safe sexual practices and reducing exposure to risk factors. Consistent and correct use of condoms during vaginal, anal, and oral sex significantly reduces the risk of transmission. Limiting the number of sexual partners and avoiding sexual activity with individuals who have symptoms of STIs can also lower the risk. Regular screening for STIs, particularly for sexually active women under 25, pregnant women, and individuals with multiple partners, is recommended. Early treatment of infections like gonorrhoea can prevent complications and reduce the spread of the infection. Education and access to healthcare services are key components of prevention efforts. Vaccines for *Neisseria gonorrhoeae* are under development but not yet available.

Prognosis of Gonorrhoea

• The prognosis for gonorrhoea is generally good with appropriate treatment. Most patients experience resolution of symptoms within a week of starting antibiotics. However, untreated or inadequately treated infections can lead to serious complications, such as pelvic inflammatory disease (PID) in women, which can cause infertility, ectopic pregnancy, or chronic pelvic pain. In men, untreated infections can result in epididymitis or urethritis. Neonatal infections can lead to conjunctivitis or systemic infections, with potential long-term consequences. Long-term outcomes are improved with early diagnosis, adherence to treatment, and addressing risk factors such as unprotected sex and multiple partners. Regular follow-up and screening are essential for preventing recurrence and complications.

Complications of Gonorrhoea

• If left untreated, gonorrhoea can lead to several complications. In women, the infection can ascend to the upper reproductive tract, causing pelvic inflammatory disease (PID), which can result in chronic pelvic pain, infertility, or ectopic pregnancy. In men, untreated infections can lead to epididymitis, characterized by testicular pain and swelling, or urethritis. Disseminated gonococcal infection (DGI), a rare but serious complication, can cause arthritis, dermatitis, or sepsis. Neonatal infections can cause conjunctivitis or systemic infections in infants born to infected mothers. Chronic or recurrent infections can lead to scarring and damage to the reproductive organs, further increasing the risk of complications. Prompt treatment and follow-up are essential to prevent these outcomes.

Related Diseases of Gonorrhoea

• Gonorrhoea is closely associated with several other sexually transmitted infections and conditions. Chlamydia, caused by *Chlamydia trachomatis*, often coexists with gonorrhoea and requires concurrent treatment. Pelvic inflammatory disease (PID) is a common complication of untreated gonorrhoea in women and can lead to chronic pelvic pain or infertility. Disseminated gonococcal infection (DGI) is a rare but serious systemic complication. Neonatal conjunctivitis and systemic infections are significant complications in infants born to infected mothers. Other STIs, such as syphilis or HIV, may occur concurrently and require comprehensive management. Understanding these related diseases is essential for accurate diagnosis and effective treatment.

Treatment of Gonorrhoea

The treatment of gonorrhoea involves antibiotic therapy to eradicate *Neisseria gonorrhoeae*. Due to increasing antibiotic resistance, dual therapy with ceftriaxone (intramuscular) and azithromycin (oral) is recommended. Sexual partners should be tested and treated to prevent reinfection. Patients are advised to abstain from sexual activity until treatment is completed and symptoms have resolved. Follow-up testing is recommended for individuals with persistent symptoms or those at high risk of reinfection. Early treatment is essential to prevent complications such as pelvic inflammatory disease (PID), infertility, or disseminated gonococcal infection (DGI). Education about safe sex practices and regular screening are key components of prevention.