Flashcards in Gonorrhoea Deck (47)
What is gonorrhoea?
A sexually transmitted infection caused the bacterium Neisseria gonorrhoea
What type of bacteria is Neisseria gonorrhoea?
A gram -ve diplococcus
What does Neisseria gonorrhoea infect?
The mucous membranes of the urethra, endocervix, rectum, pharynx and conjunctiva
What parts of the body can be affected by gonorrhoea?
How does gonorrhoea spread?
By direct inoculation of infected secretions from one mucous membrane to another
When can gonorrhoea be transmitted?
Usually sexually but can occur perinatally
What is the incubation period of gonorrhoea?
2-5 days but can be up to 10
How many cases of gonorrhoea were diagnosed in England in 2017?
Which group of people have a disproportionate increase in gonorrhoea cases?
What is thought to have caused the increase in cases of gonorrhoea?
- More young men coming forward for testing
- Increasing unsafe sex
Where is gonorrhoea more common?
What are the risk factors for gonorrhoea?
- Young age
- History of previous STI
- Co-existent STI
- New or multiple sexual partners
- Recent sexual activity abroad
- Certain sexual activities
- Inconsistent condom use
- History of drug use or commercial sex work
What sexual activities are particularly risky for gonorrhoea transmission?
- Anal intercourse
- Frequent insertive oral sex
Which sex is gonorrhoea more commonly symptomatic in?
What percentage of women with gonorrhoea are symptomatic?
What do symptoms of gonorrhoea depend on?
The site of infection
What are the symptoms of urethral gonorrhoea infection in men?
- Asymptomatic in <10% of cases
What are the symptoms of rectal gonorrhoea infection in men?
- Usually asymptomatic
- Anal discharge
- Perianal/anal pain
How does pharyngeal gonorrhoea infection usually present in men and women?
How does endocervical gonorrhoea infection present?
- Up to 50% asymptomatic
- Increased or altered vaginal discharge (up to 50% of cases)
- Lower abdominal pain
- Intermenstrual bleeding or menorrhagia
What are the symptoms of urethral gonorrhoea infection in women?
- Dysuria without frequency
How does rectal gonorrhoea infection present in women?
What are the differentials for gonorrhoea?
- Bacterial vaginosis
- Urinary tract infection
How was gonorrhoea traditionally investigated?
Culture for diagnosis and sensitivity testing
What is overtaking culture as the main diagnostic test for gonorrhoea?
NAAT (nucleic acid amplification testing)
When is culture still necessary?
- In positive NAAT tests to ensure resistant strains are identified
- Signs and symptoms consistent with gonorrhoea
How can samples for gonorrhoea NAAT be taken?
- Urethral/endocervical swabs
- First pass urine
When should a patient be referred to a GUM clinic for gonorrhoea?
If they have symptoms or is at high risk or has tested positive
What are the management aspects in gonorrhoea?
- Give advice
- Partner notification
- Drug treatment