Gonococcal Infection

Gonococcal infection is an STD caused by N. gonorrhoeae, mainly purulent urogenital infection. Sexually transmitted; infected mothers infect neonates via birth canal; rarely via fomites. Men: urethritis; women: vaginitis/cervicitis; symptoms: dysuria, frequency, urgency, purulent/mucous discharge. Also eyes/pharynx/rectum/pelvis and DGI (arthritis/perihepatitis/septicemia/endocarditis/meningitis). Gram stain of urethral/cervical discharge shows intracellular Gram-negative diplococci. Treat promptly/adequately; treat partners simultaneously. Ofloxacin 400-600 mg PO; spectinomycin 2 g IM (men) / 4 g IM (women). Cure = symptoms resolved and smears/cultures negative at 4-7 days.

Common Symptoms

Station doctor; dysuria; frequency; anorexia; lower back pain; odynophagia; abdominal pain; nausea; testicular tenderness

Causes and Pathogenesis

Caused by unprotected sex; easily recurs with severe complications. N. gonorrhoeae is a Gram-negative kidney-shaped diplococcus 0.6-0.8 µm, non-flagellated, non-capsulated, non-spore; intracellular in pus; grows at pH 7.0-7.5, 35-36°C, 5-10% CO2; colonies are round, convex, smooth, gray-white, petal-edged, typed T1-T5 by size/luster; T1/T2 are virulent (piliated), T3-T5 avirulent. Surface antigens: pili, LPS, outer-membrane proteins. Environmental resistance is weak: dies in 1-2 h dry, 55°C/5 min, room temp 1-2 days; sensitive to disinfectants/antibiotics. Pathogenesis: urine normally sterile; gonococci preferentially colonize anterior urethra/cervix/posterior urethra/bladder (columnar/transitional epithelium); acid urine (pH<5.5) kills them (bladder/kidney rarely infected); prostatic spermine/zinc favors infection. Lactoferrin limits iron availability. Pili/Opa proteins mediate adhesion and intracellular uptake; endotoxin LPS + complement + IgM cause inflammation; symptoms at ~30 h (edema/adhesion/pus). Complications: prostatitis, seminal vesiculitis, epididymitis, endometritis; long-term fibrosis causes urethral/vas/deferential/tubal obstruction leading to male infertility/ectopic pregnancy.

Treatment

Drug therapy, supportive therapy

Preventive Measures

1. Avoid non-marital sex. 2. Disinfect personal items; gonococci die in 1-2 h dry, by boiling/sunlight/bleach/iodophor. 3. Use squat toilets in public. 4. Credé eye prophylaxis for neonates.

Department to Visit

It is recommended to visit the Infectious Diseases 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.