Gonorrhea has been in existence for ages, in United Kingdom for instance, it is the second most common bacterial venereal infection. considering the pathophysiology of gonorrhea, the good news is that, it can be cured using the right medications.
Gonorrhea is a bacterial disease caused by a gram-negative pathogen called Neisseria gonorrhea.
Neisseria gonorrheae is an obligate human pathogen that causes mucosal surface infections of male and female reproductive tracts, pharynx, rectum, and conjunctiva. It predominantly affects people below 30 years of age.
If asymptomatic in the lower reproductive tract of women, it can lead to serious, long-term consequences if these infections ascend into the fallopian tube.
The damage caused by gonococcal infection and the subsequent inflammatory response produce the condition known as pelvic inflammatory disease (PID).
Additionally, the resolution of infection can produce new adhesions between internal tissues, which can tear and reform, producing chronic pelvic pain.
Signs and symptoms in the pathophysiology of gonorrhea
The first sign in the male is a burning sensation upon urination and a purulent urethral discharge that may or may not be pronounced.
In the absence of treatment, the infection usually extends deeper, to involve the upper urethra, the neck of the urinary bladder, and the prostate gland.
Urgency and frequency of urination and, occasionally, blood in the urine may follow.
This infection is usually asymptomatic in about 20 percent of infected women very few men have the infection without any sign.
Signs of Gonorrhea affecting the genital tract in men include:
- Painful urination
- Pus-like discharge from the tip of the penis
- Pain or swelling in one testicle
Signs of Gonorrhea affecting the genital tract in women include:
- Increased vaginal discharge
- Painful urination
- Vaginal bleeding between periods, such as after vaginal intercourse
- Abdominal or pelvic pain
Signs of Gonorrhoea at other sites in the body include:
The eyes can be affected following Gonorrhoea infection which can lead to eye pain, sensitivity to light, and pus-like discharge from one or both eyes and other visual impairments.
Once the rectum is infected symptoms may include anal itching, pus-like discharge from the rectum, spots of bright red blood on toilet tissue and having to strain during bowel movements.
Signs and symptoms of a throat infection might include a sore throat and swollen lymph nodes in the neck region.
Following a gonorrhoea infection, the joints may become infected leading to septic arthritis which is accompanied by difficulty in movement.
Gonorrhea Risk Factors
For most venereal diseases the surest way to keep safe is abstinence. in this article “pathophysilogy of gonorrhea”
The risk for gonorrhea is higher if you:
- Fall below 30 years of age
- Are having sex with a new partner who is promiscuous
- Have multiple sex partners
- Are exposed to gonorrhea before
- Have had other STDs
Pathophysiology of gonorrhoea
The incubation period of gonorrhea is usually 3 to 5 days (range 2 to 10 days). The pathophysiology of N gonorrhea and the relative virulence of different subtypes depend on the antigenic characteristics of the respective surface proteins.
Certain subtypes are able to evade serum immune responses and are more likely to lead to disseminated (systemic) infection.
Well-characterized plasmids commonly carry antibiotic-resistance genes, most notably penicillinase. Plasmid and nonplasmid genes are transmitted freely between different subtypes
Unlike many commonly studied bacterial pathogens, N. gonorrhoeae is not readily adaptable to laboratory animal models due to its exquisite adaptation to the human host thus making it a difficult for study.
A female mouse model was developed nearly 20 years ago. With refinement in the intervening time, this model has proven very useful, especially in the understanding of complex systemic immune responses model.
Prevention of gonorrhea
As earlier stated, the safest way to prevent gonorrhea or other STDs is through abstinence. If you do engage in sex, always use a condom.
It’s important to be open with your sexual partners, get regular STD testing, and find out if they’ve been tested.
If your partner is showing signs of a possible infection, avoid any sexual contact with them. Ask them to seek medical attention to rule out any possible infection that can be passed on.
You are at a higher risk of contracting gonorrhoea if you have already had it or any other STDs.
You are also at a higher risk if you have multiple sexual partners or a new partner.
Treatment of gonorrhea/ gonorrhea antibiotics
Seek medical advice from a physician before taking any medication
- For uncomplicated infection, a single dose of ceftriaxoneplus azithromycin
Uncomplicated gonococcal infection of the urethra, cervix, rectum, and pharynx is treated with the following:
- Preferred: A single dose of ceftriaxone250 mg IM plus azithromycin 1 g orally
- Alternative: A single dose of cefixime400 mg orally plus azithromycin 1 g orally
In patients who have an azithromycin allergy or who immediately vomit the drug, doxycycline 100 mg orally twice a day for 7 days is an alternative to azithromycin as a second antimicrobial.
Patients who are allergic to cephalosporins are treated with one of the following:
- Gemifloxacin320 mg orally plusazithromycin 2 g orally once
- Gentamicin240 mg IM plus azithromycin 2 g orally once
Monotherapy and previous oral regimens of fluoroquinolones (eg, ciprofloxacin, levofloxacin, ofloxacin) or cefixime are no longer recommended because of increasing drug resistance.
Test of cure is recommended only for patients treated with an alternative regimen for pharyngeal infections.
DGI with gonococcal arthritis is initially treated with IM or IV antibiotics (eg, ceftriaxone 1 g IM or IV every 24 hours, ceftizoxime 1 g IV every 8 hours, cefotaxime 1 g IV every 8 hours) continued for 24 to 48 hours once symptoms lessen, followed by 4 to 7 days of oral therapy.
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