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Gynaecologic Problems: Gonorrhoea

Description

Gonorrhoea is caused by gonococcus , a bacterium that grows and multiplies quickly in moist, warm areas of the body such as the cervix , urethra, mouth, or rectum. In women, the cervix is the most common site of infection. However, the disease can spread to the uterus (womb) and fallopian tubes , resulting in pelvic inflammatory disease (PID); this can cause infertility and ectopic (tubal) pregnancy . Gonorrhoea is most commonly spread during genital contact, but it can also be passed from the genitals of one partner to the throat of the other during oral sex ( pharyngeal gonorrhoea ). Gonorrhoea of the rectum can occur in people who practice anal intercourse and may also occur in women due to spread of the infection from the vaginal area.

Symptoms and Signs

The early symptoms of gonorrhoea often are mild, and most women who are infected have no symptoms of the disease. If symptoms of gonorrhoea develop, they usually appear within 2 to 10 days after sexual contact with an infected partner, although a small percentage of patients may be infected for several months without showing symptoms. The initial symptoms in women include a painful or burning sensation when urinating or an abnormal vaginal discharge. More advanced symptoms, which indicate progression to pelvic inflammatory disease (PID), include abdominal pain, bleeding between menstrual periods, vomiting, or fever. Symptoms of rectal infection include discharge, anal itching, and sometimes painful bowel movements.

Diagnosis and Treatment

Ampicillin, amoxicillin, or some type of penicillin used to be recommended for the treatment of gonorrhoea Because penicillin-resistant gonorrhoea is increasing, other antibiotics that are given by injection such as ceftriazone or spectinomycin now are used to treat most gonoccal infections. Other new antibiotics can be taken by mouth.

Gonorrhoea often occurs together with chlamydial infection. Therefore, doctors usually prescribe a combination of antibiotics, such as ceftriazone and doxycycline, to treat both diseases. All sex partners of a person with gonorrhoea should be tested and treated appropriately, even if they do not have symptoms of infection.

If gonorrhoea is not treated, the bacteria can spread to the bloodstream and infect the joints, heart valves, or the brain. The most common consequence of gonorrhoea, however, is PID.

Gonorrhoea & Pregnancy

An infected woman who is pregnant may give the infection to her infant as the baby passes through the birth canal during delivery. Most states require that the eyes of newborns be treated with silver nitrate or other medication immediately after birth to prevent gonococcal infection of the eyes, which can lead to blindness. Because of the risk of gonococcal infection to both mother and child, doctors recommend that a pregnant woman have at least one test for gonorrhoea during her pregnancy. Women who are pregnant should not take doxylcycline and usually are given an alternative antibiotic such as erythromycin.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. The National Women's Health Information Center (NWHIC) FAQs: http://www.4woman.gov/faq/


Other HON resources 
   From MedHunt
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Gonorrhoea in women
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Neisseria gonorrhoeae
Gonorrhea:
(www.hon.ch)
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  http://www.hon.ch/Dossier/MotherChild/gynae_problems/std_gonorrhea.html Last modified: Jun 25 2002