Gonorrhea

Gonorrhea is purulent urogenital infection by N. gonorrhoeae, also involving eyes/pharynx/rectum/pelvis and DGI. Sexually transmitted; rarely via purulent fomites; mothers transmit to neonates via birth canal.

Common Symptoms

Papulomacular rash; dull pain; back pain; inflammation; bone destruction; Yan Hongmei; fatigue; nausea

Causes and Pathogenesis

N. gonorrhoeae is a kidney/Gram-negative diplococcus 0.6-0.8 × 0.5 µm, non-flagellated, non-spore; intracellular in acute disease, extracellular in chronic. Methylene blue stains blue; Pappehheim Saathof stains red on sky-blue background. Five colony types T1-T5; T1/T2 are virulent piliated, T3/T4/T5 are non-piliated non-infectious. Outer membrane (membrane proteins, LPS, pili) mediates adhesion/intracellular survival. It is fastidious: prefers moisture, 35-36°C, 2.5-5% CO2, pH 7.0-7.5; dies 1-2 h dry, but survives 18-24 h on clothing, days in thick pus, 50°C/5 min; sensitive to silver salts (1:4000 AgNO3 kills in 7 min), 1% phenol in 3 min. Neisser isolated it in 1879; Bumm cultured it in 1885. Ferments glucose but not fructose; oxidase-positive. 35 auxotypes; Arg/Hyx/Ura cause asymptomatic/DGI. Pathogenesis: (1) tropism for columnar/transitional epithelium (urethra/cervix), not stratified squamous (fossa/vagina); prepubertal vaginal columnar epithelium is susceptible. (2) adhesion via pili/Opa/IgA1 protease. (3) internalization and transcytosis. (4) inflammation at ~36 h with pus. (5) spread to prostate/seminal vesicles/vas deferens/epididymis in men; uterus/tubes/pelvis in women; hematogenous DGI.

Treatment

Drug therapy, supportive therapy

Preventive Measures

Do not share beds/baths with children (especially girls); eye prophylaxis for all neonates in high-prevalence areas. Health education, condoms, prophylactic antibiotics (norfloxacin/amoxicillin before/after sex), treat partners, isolate patients, Credé prophylaxis.

Department to Visit

It is recommended to visit the STD department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.