2. INTRODUCTION
Common STD; caused by the bacterium Neisseria
gonorrhoeae.
Transmission: Sexual intercourse (vaginal, oral, or anal)
Congenital (infected mothers to newborn
infants)
Incubation period:
15 to 30 days (most symptoms occur b/n 15 – 20th day).
Very few cases (both males and females) are asymptomatic
for life.
Symptoms:
In females - vaginal discharge; difficulty urinating (dysuria);
off-cycle menstrual bleeding; bleeding after sexual
intercourse;
↑ed production of male hormones; urethritis and
cystitis; cervical inflammation w/ purulent discharge.
3. Symptoms (contd’.)
• Also affects the rectum, the throat (oropharynx) and
the eyes (conjunctiva).
• ‘Ophthalmia neonatorum’ – mother to child;
conjunctivitis (causes blindness, if untreated;
use erythromycin drops).
• In males - pain on urinating;
thick, copious, urethral pus discharge (gleet);
Ascending infection - involves epididymis, testicles or
prostate gland causing symptoms such as scrotal pain
or swelling.
4. Symptoms (contd.)
Less advanced symptoms - cramps, pain, bleeding b/n
menstrual periods, vomiting, fever (indicate
development of pelvic inflammatory disease / PID).
Blurred vision (may occur in adults).
5. COMPLICATIONS
Males: epididymitis, prostatitis and urethritis
( untreated gonorrhea).
Females: Pelvic inflammatory disease → Infertility.
Other complications : Perihepatitis, Fitz-Hugh-Curtis
syndrome; septic arthritis in fingers, wrists, toes, and
ankles; chorioamnionitis during pregnancy;
conjunctivitis (neonatal or adult blindness); and
infertility.
The underlying gonorrhea should be treated; if this is
done then usually a good prognosis will follow.
• Fitz-Hugh-Curtis syndrome : Rare complication of PID; involves liver capsule
inflammation.
• Chorioamnionitis : Inflammation of the fetal membranes.
6. TREATMENT
Antibiotics used to treat gonorrhea include:
• Amoxicillin 2 g + probenecid 1 g orally
• Ampicillin 2 to 3 g + probenecid 1 g orally
• Azithromycin 2 g orally
• Cefixime or Suprax 400 mg orally
• Cefotaxime 500 mg by IM injection
• Cefoxitin 2 g by IM injection + probenecid 1 g orally
• Cefpodoxime (Vantin) 400 mg orally
• Ceftriaxone (Rocephin) 125 to 250 mg by IM injection
• Ciprofloxacin 500 mg orally
• Levofloxacin 250 mg orally
• Ofloxacin 400 mg orally
• Spectinomycin 2 g by IM injection
These drugs are all given as a single dose.
7. Update: www.dailymail.co.uk
• Doctors warn that antibiotic-resistant strain of gonorrhea could be
'worse than AIDS'
• Gonorrhea is the second most commonly reported sexually
transmitted disease in the U.S.
• A growing number of cases are being reported globally of an
antibiotic-resistant strain known as HO41
• It has been listed as a superbug and doctor are warning it has the
potential to become very dangerous very quickly
• Gonorrhea is especially common amongst young people aged 15-24
• PUBLISHED: 13:49 GMT, 1 May 2013 | UPDATED: 13:49 GMT, 1 May
2013
• Doctors are warning that an antibiotic-resistant strain of gonorrhoea,
now considered a superbug, has the potential to be as deadly as the
AIDS virus.
8. • Gonorrhea is the second most commonly reported sexually
transmitted infection in North America.
• This particular strain of gonorrhea, known as HO41, was discovered
in Japan two years ago in a 31-year-old female sex worker who had
been screened in 2009. The bacteria has since been found in Hawaii,
California and Norway.
• HO41 has so far proved resistant to current antibiotic treatment and
so it has been placed in the superbug category.
• ‘This might be a lot worse than AIDS in the short run because the
bacteria is more aggressive and will affect more people quickly,’ Alan
Christianson, a doctor of naturopathic medicine told CNBC.
• Nearly 30 million people have died from AIDS related causes
worldwide, but Christianson believes the effect of the gonorrhea
bacteria is more direct.
9. • ‘Getting gonorrhea from this strain might put someone into septic shock
and death in a matter of days,’ Christianson said. ‘This is very
dangerous.’
• In a briefing on Capitol Hill last week, William Smith, executive director of the
National Coalition for STD Directors, urged Congress to target nearly $54
million in immediate funding to help find an antibiotic for HO41 and to
conduct an education and public awareness campaign.
• Although no deaths from HO41 have been reported as yet, experts say
avoiding the disease completely is the best course of action.
• ‘People need to practice safe sex, like always,’ Christianson said. ‘Anyone
beginning a new relationship should get tested along with their partner.
• 'The way gonorrhea works, not everyone knows they have it. And with
this new strain it's even more important than ever to find out.’
• Gonorrhea is a sexually transmitted disease that has been known since
medieval times. Sometimes known as ‘the clap,’ the infection can result in
painful sores and genital discharge, and is associated with ectopic
pregnancies and sterility in both men and women.
10. • Left untreated, gonorrhea can lead to a host of complications including
pelvic inflammatory disease, infertility, and blood stream infections.
• It also raises the risk for HIV because the lesions permit the AIDS-causing
virus easier access to the bloodstream.
• Gonorrhea is especially common among people between the ages of 15 and
24.
• The disease became curable in the 1940s when penicillin and other
antibiotics were introduced. Since then, the medical world has created more
new drugs that killed the ever-mutating gonorrhea bacteria.
• Cephalosporin, the last available class of antibiotics recommended for the
treatment of gonorrhea, has been failing worldwide and there is the very
real prospect that all types of gonorrhea will soon become untreatable.
• Professor Cathy Ison, head of the National Reference Laboratory for
Gonorrhoea in the U.K. told the BBC last week: ‘There is a possibility that if
we don't do something then it could become untreatable by 2015.’
Courtesy: http://www.dailymail.co.uk/news/article-2317690/Doctors-warn-antibiotic-
resistant-strain-gonorrhea-worse-AIDS.html
