Gonorrhea (clap, drip)
Source :
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004526/
Source:
http://en.wikipedia.org/wiki/Gonorrhea
Causes, incidence, and risk factors
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. Anyone who has any type of sex can catch gonorrhea. The infection can be spread by contact with the mouth, vagina, penis, or anus.
The bacteria grow in warm, moist areas of the body, including the tube that carries urine out of the body (urethra). In women, the bacteria may be found in the reproductive tract (which includes the fallopian tubes, uterus, and cervix). The bacteria can even grow in the eyes.
Health care providers in every state in the U.S. are required by law to tell their State Board of Health about anyone diagnosed with gonorrhea. The goal of this law is make sure the patient gets proper follow-up care and that their sexual partners are found and tested.
More than 700,000 persons in the United States get gonorrhea every year, according to the Centers for Disease Control and Prevention (CDC).
Gonorrhea is more common in large cities, inner-city areas, populations with lower overall levels of education and people with lower socioeconomic status.
You are more likely to develop this infection if you:
Have multiple sexual partners
Have a partner with a past history of any sexually transmitted disease
Do not use a condom during sex
Have a drug addiction
Symptoms
Symptoms of gonorrhea usually appear 2 - 5 days after infection, however, in men, symptoms may take up to a month to appear. Some people do not have symptoms. They may be completely unaware that they have caught the disease, and therefore do not seek treatment. This increases the risk of complications and the chances of passing the infection on to another person.
Symptoms in men include:
Burning and pain while urinating
Increased urinary frequency or urgency
Discharge from the penis (white, yellow, or green in color)
Red or swollen opening of penis (urethra)
Tender or swollen testicles
Sore throat (gonococcal pharyngitis)
Symptoms in women can be very mild or nonspecific, and may be mistaken for another type of infection. They include:
Vaginal discharge
Burning and pain while urinating
Increased urination
Sore throat
Painful sexual intercourse
Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and stomach area)
Fever (if the infection spreads to the fallopian tubes and stomach area)
If the infection spreads to the bloodstream, fever, rash, and arthritis-like symptoms may occur. See: Disseminated gonococcemia
Signs and tests
Gonorrhea can be quickly identified by staining a sample of tissue or discharge and then looking at it under a microscope. This is called a gram stain. Although this method is fast, it is not the most certain.
Gram stain tests used to diagnose gonorrhea include:
Cervical gram stain in women
Gram stain of urethral discharge in men
Joint fluid gram stain
Cultures (cells that grow in a lab dish) provide absolute proof of infection. Generally, samples for a culture are taken from the cervix, vagina, urethra, anus, or throat. Cultures
can provide a preliminary diagnosis often within 24 hours and a confirmed diagnosis within 72 hours.
Cultures used to diagnose gonorrhea include:
Endocervical culture in women
Urethral discharge culture in men
Throat swab culture in both men and women
Rectal culture in both men and women
Culture of joint fluid
Blood cultures
DNA tests are especially useful as a screening test. They included the ligase chain reaction (LCR) test. DNA tests are quicker than cultures. Such tests can be performed on urine samples, which are a lot easier to collect than samples from the genital area.
Treatment
There are two goals in treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infection in the patient. The second is to locate and test all of the other people the person had sexual contact with and treat them to prevent further spread of the disease.
Never treat yourself without being seen by your doctor first. Your health care provider will determine the best and most up-to-date treatment. The U.S. Centers for Disease Control and Prevention (CDC) recommends the following treatments for uncomplicated gonorrhea.
A single shot of ceftriaxone (Rocephin) 125 mg or a single dose of cefixime 400 mg taken by mouth are currently the recommended antibiotic treatment
Azithromycin (Zithromax) 2g in a single dose may be used for people who have severe allergic reactions to ceftriaxone, cefixime, or penicillin.
Penicillin used to be the standard treatment, but it is not used any longer because it does not cure gonorrhea all the time. The CDC also recommendeds against using a class of antibiotics called fluoroquinolones (ciprofloxacin, ofloxacin, or levofloxacin).
Persons with gonorrhea often also have a chlamydia infection. If a chlamydia culture was not done to rule out this infection, a single dose of azithromycin (1g by mouth) or doxycycline 100 mg twice a day, by mouth for 7 days should also be given.
A follow-up visit 7 days after treatment is important if joint pain, skin rash, or more severe pelvic or belly pain is present. Tests will be done to make sure the infection is gone.
All sexual contacts of the person with gonorrhea should be contacted and tested. This helps prevent further spread of the disease. In some places you may be able to take counseling information and medicines to your sexual partner yourself. In other places, the health department will contact your partner.
Expectations (prognosis)
Immediately treating a gonorrhea infection helps prevent permanent scarring and infertility. When treatment is delayed there is a greater chance of complications and sterility.
About half of the women with gonorrhea are also infected with chlamydia, another very common sexually transmitted disease that can result in sterility. Chlamydia is treated at the same time as a gonorrhea infection.
If you have gonorrhea, you should ask to be tested for other sexually transmitted diseases, including chlamydia, syphilis, and HIV. You should also receive the hepatitis B vaccine.
Complications
Complications in women may include:
Salpingitis (scarring of the fallopian tubes), which can lead to problems getting pregnant or ectopic pregnancy
Pelvic inflammatory disease
Sterility (inability to become pregnant)
Painful intercourse (dyspareunia)
Pregnant women with severe gonorrhea may pass the disease to their baby while in the womb or during delivery
Complications in men may include:
Scarring or narrowing of the urethra, the tube that carries urine out of the body (See: Urethral stricture)
Abscess (collection of pus around the urethra)
Urination problems
Urinary tract infection
Kidney failure
Complications in both men and women may include:
Disseminated infection, which can be very serious
Long-term joint pain, if the infection is left untreated
Heart valve infection
Meningitis
Prevention
Not having sexual intercourse (abstinence) is the only absolute method of preventing gonorrhea. A monogamous sexual relationship with an individual known to be free of any STD can reduce risk. Monogamous means you and your partner do not have sex with any other persons.
You can greatly lower your risk of catching an STD by using a condom every time you have sex. Condoms are available for both men and women, but are most commonly worn by the man. A condom must be used properly every time. (For instructions on how to use a condom, see safe sex.)
Epidemiology
Gonorrhea is a common infectious disease. In the United Kingdom 196 per 100,000 males 20-24 year old, and 133 per 100,000 females 16-19 year were diagnosed in 2005.[2] The CDC estimates that more than 700,000 people in the United States get new gonorrheal infections each year. Only about half of these infections are reported to CDC. In 2004, 330,132 cases of gonorrhea were reported to the CDC. After the implementation of a national gonorrhea control program in the mid-1970s, the national gonorrhea rate declined from 1975 to 1997. After a small increase in 1998, the gonorrhea rate has decreased slightly since 1999. In 2004, the rate of reported gonorrheal infections was 113.5 per 100,000 persons.[15]
In the US, it is the second most common bacterial sexually transmitted infections after chlamydia[16][17]
