Gonococcal Infections
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Basics
Description
A sexually or vertically transmitted bacterial infection caused by Neisseria gonorrhoeae:
- N. gonorrhoeae is a fastidious gram-negative intracellular diplococcus (1)[A].
- Presents as conjunctival, pharyngeal, urogenital, or anorectal infection. Urogenital infections are the most common (1)[A].
- Hematogenous dissemination leads to fever, cutaneous lesions, arthralgias, purulent or sterile arthritis, tenosynovitis, endocarditis, or (rarely) meningitis (1)[A].
- Asymptomatic carrier states occur in men and women
- In newborns of infected mothers, gonococcal ophthalmia neonatorum, a purulent conjunctivitis, may occur after vaginal delivery. Can lead to potential blindness if not treated promptly (1,2)[A].
- System(s) affected: cardiovascular, musculoskeletal, nervous, reproductive, skin/exocrine
- Synonym(s): gonococcal infection; clap
Epidemiology
- Predominant age: 15- to 44-year-olds account for 92% of cases; highest rate among those ages 20 to 24 years
- Predominant sex: Men 213/100,000; Women 146/100,000
Incidence
Centers for Disease Control and Prevention (CDC) 2018: 583,405 reported cases
Incidence and prevalence are roughly equal. The true prevalence is higher due to asymptomatic cases (2)[A]:
Etiology and Pathophysiology
Infection requires four steps: (i) mucosal attachment—bacterial proteins bind to receptors on host cells, (ii) local penetration/invasion, (iii) local proliferation, (iv) inflammatory response or dissemination. N. gonorrhoeae spreads most commonly through sexual contact.
Genetics
Deficiency of late components of complement cascade (C7–C9) predisposes to disseminated disease.
Risk Factors
- History of previous gonorrhea infection or other STIs
- Sexual exposure to an infected individual without appropriate use of barrier protection (condom)
- New/multiple sexual partners
- Inconsistent condom use
- Commercial sex work or drug use
- Infants: infected mother
- Children: sexual abuse by infected individual
- Autoinoculation (finger to eye)
General Prevention
Commonly Associated Conditions
Other STIs: Chlamydia, syphilis, HIV, hepatitis B, herpes (2,3)[A]
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
A sexually or vertically transmitted bacterial infection caused by Neisseria gonorrhoeae:
- N. gonorrhoeae is a fastidious gram-negative intracellular diplococcus (1)[A].
- Presents as conjunctival, pharyngeal, urogenital, or anorectal infection. Urogenital infections are the most common (1)[A].
- Hematogenous dissemination leads to fever, cutaneous lesions, arthralgias, purulent or sterile arthritis, tenosynovitis, endocarditis, or (rarely) meningitis (1)[A].
- Asymptomatic carrier states occur in men and women
- In newborns of infected mothers, gonococcal ophthalmia neonatorum, a purulent conjunctivitis, may occur after vaginal delivery. Can lead to potential blindness if not treated promptly (1,2)[A].
- System(s) affected: cardiovascular, musculoskeletal, nervous, reproductive, skin/exocrine
- Synonym(s): gonococcal infection; clap
Epidemiology
- Predominant age: 15- to 44-year-olds account for 92% of cases; highest rate among those ages 20 to 24 years
- Predominant sex: Men 213/100,000; Women 146/100,000
Incidence
Centers for Disease Control and Prevention (CDC) 2018: 583,405 reported cases
Incidence and prevalence are roughly equal. The true prevalence is higher due to asymptomatic cases (2)[A]:
Etiology and Pathophysiology
Infection requires four steps: (i) mucosal attachment—bacterial proteins bind to receptors on host cells, (ii) local penetration/invasion, (iii) local proliferation, (iv) inflammatory response or dissemination. N. gonorrhoeae spreads most commonly through sexual contact.
Genetics
Deficiency of late components of complement cascade (C7–C9) predisposes to disseminated disease.
Risk Factors
- History of previous gonorrhea infection or other STIs
- Sexual exposure to an infected individual without appropriate use of barrier protection (condom)
- New/multiple sexual partners
- Inconsistent condom use
- Commercial sex work or drug use
- Infants: infected mother
- Children: sexual abuse by infected individual
- Autoinoculation (finger to eye)
General Prevention
Commonly Associated Conditions
Other STIs: Chlamydia, syphilis, HIV, hepatitis B, herpes (2,3)[A]
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