ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferencesInformation for PatientsView all Images (7)
Primary gonorrhea infection - Anogenital in
See also in: Overview
Print
Other Resources UpToDate PubMed

Primary gonorrhea infection - Anogenital in

See also in: Overview
Print Patient Handout Images (7)
Contributors: Saami Khalifian MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Gonorrhea is a common sexually transmitted infection caused by the gram-negative intracellular diplococcus Neisseria gonorrhoeae. It is highly contagious and primarily spread through sexual contact, although it can also be passed to the fetus from a pregnant woman during childbirth or via indirect contact through sharing of contaminated objects. There appears to be a higher rate of gonorrheal infection in women than men, although the overall incidence is likely underreported.

The incubation period of N. gonorrhoeae is short. The average time from infection to symptom onset is approximately 2-7 days. Risk factors for acquiring N. gonorrhoeae include having a new sex partner, more than one sex partner (or a sex partner with concurrent partners), and a history of sexually transmitted diseases (STDs) (or a sex partner with a history of STDs). Other risk factors include inconsistent condom use (if not in a mutually monogamous relationship), young age, and substance abuse. Some subgroups of men who have sex with men (MSM) are at higher risk as well.

The endocervical canal is the most common site of infection in women. Symptoms typically include dysuria, vaginal discharge, bleeding, and menstrual pain. Pelvic inflammatory disease (PID) occurs in 20% of patients as a result of ascending endocervical infection. Clinical features of PID include lower abdominal and adnexal pain, fever, and leukocytosis. Rarely, PID can cause further peritoneal and hepatic inflammation, leading to right upper quadrant pain and gonorrheic perihepatitis (Fitz-Hugh-Curtis syndrome). Chronic untreated PID may lead to tubal scarring with resultant infertility or ectopic pregnancy.

Proctitis and pharyngitis occurs in both sexes via direct mucosal infection, but the former is more prevalent in MSM.

Systemic symptoms including fever, arthritis, tenosynovitis of large joints, and cutaneous pustules can occur from hematogenous dissemination. This occurs in less than 1% of patients. Risk factors for dissemination include menstruation and complement deficiency.

Related topics: Disseminated Gonorrhea, Gonococcal Cervicitis, Gonococcal Conjunctivitis

Codes

ICD10CM:
A54.9 – Gonococcal infection, unspecified

SNOMEDCT:
15628003 – Gonorrhea

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

For PID, differential diagnosis includes:

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

References

Subscription Required

Last Reviewed: 05/22/2017
Last Updated: 06/06/2017
Copyright © 2018 VisualDx®. All rights reserved.
Primary gonorrhea infection - Anogenital in
See also in: Overview
Print 7 Images
View all Images (7)
(with subscription)
Primary gonorrhea infection (Male) : Testicular tenderness, Urethral pus, Dysuria, Sexually active
Clinical image of Primary gonorrhea infection
Copyright © 2018 VisualDx®. All rights reserved.