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Neisseria gonorrhoeae is the name of the bacterium that causes gonorrhea, which is a sexually transmitted disease. This bacterium can easily grow and multiply in the warm and moist areas of the reproductive tract, including the urethra in women and men, and the uterus, fallopian tubes and cervix in women.

However, this bacterium can also grow in the eyes, mouth, anus and throat.


Contact with the mouth, penis, anus or vagina of an infected person spreads gonorrhea. For gonorrhea to be transmitted or acquired, ejaculation isn’t important. During delivery, gonorrhea can also spread from the mother to her baby. If people who have had gonorrhea have sexual contact with a person infected with gonorrhea, they can become re-infected.



Usually, the symptoms of gonorrhea appear within 2 to 10 days after sexual contact with an infected person. However, the symptoms may sometimes not appear until 30 days after sexual contact. A small number of people could be infected for several months without showing any symptoms. The bacteria from gonorrhea can cause discharge since they are carried in semen and vaginal fluids.



Early gonorrhea symptoms are usually mild in women. They may include:


  • Yellow or bloody vaginal discharge
  • Bleeding associated with vaginal intercourse
  • Burning or painful sensation when urinating


Vomiting, cramps and pain, fever, and bleeding between menstrual periods are some of the more advanced symptoms in women that may indicate the development of pelvic inflammatory disease (PID).



Men have symptoms of gonorrhea more often than women. Some of the symptoms in men may be:


  • Burning sensations during urination that may be severe
  • Swollen testicles
  • White, yellow, or green pus from the penis with pain


Anal itching, discharge, and occasional, painful bowel movements with fresh blood in the feces are some of the gonorrhea symptoms of a rectal infection. But sometimes, a rectal infection may cause no symptoms of gonorrhea.



Usually, a gonorrheal infection in the throat doesn’t cause any symptoms; but sometimes, it may cause a sore throat. Itching, discharge from the eye and redness are some of the symptoms of gonorrheal infections in the eyes.



Any sexually active person can be infected with gonorrhea; because of this, gonorrhea is known as “silent”.


Serious life-threatening complications may result in case a gonorrhea infection is left untreated. The bacteria can spread into the reproductive tract when the infection is left untreated, or in some rare cases, it can spread into the bloodstream and infect the brain, heart valves or joints.


Pelvic inflammatory disease (PID) is the most common result of untreated gonorrhea. PID is a serious infection of the female reproductive tract. Gonococcal PID causes scar tissue to form in the fallopian tubes, and it usually appears immediately after the menstrual period. The fertilized egg may not be able to pass into the uterus if the tube is partially scarred, meaning that the embryo may implant in the tube resulting in an ectopic or tubal pregnancy. Miscarriage may result from this serious complication, and it can end up causing the mother’s death.


Gonorrhea can cause epididymitis in men, a painful condition of the testicles that can lead to infertility if left without treatment. Gonorrhea may also cause scarring in the urine canal, and it may affect the prostate gland.


Gonorrhea that is left untreated can spread through the blood to the joints in some rare cases. This can result in a serious condition; inflammation of the joints. The risk of getting HIV is increased in people with gonorrhea. Because of this, trying to prevent a gonorrhea infection and getting treated early if already infected is quite important.


The risk of preterm delivery, miscarriage and having the water break too early is increased in women who have untreated gonorrhea.


Because of the risks presented by gonococcal infection to both the mother and the baby, health experts recommend that pregnant women have at least one test for gonorrhea during prenatal care.



Changes in the established treatment for gonorrhea infections were recommended in 2007 by the CDC, based upon the results of a study called the Gonococcal Isolate Surveillance Project (GISP), which has tested individually-isolated samples of N. gonorrheae for susceptibility to treatment by different antibiotics.


In the treatment of gonorrheal infection, a class of antibiotics called fluoroquinolones that include ofloxacin, ciprofloxacin and levofloxacin, were widely used. However, the CDC now recommends that only one class of antibiotics, the cephalosporins, be used to treat gonorrheal infections, because of the increasing resistance of many tested samples of N. gonorrheae to the fluoroquinolone drugs.


Some examples of cephalosporins are:


  • Cefoxitin
  • Cefotaxime
  • Ceftazidime
  • Cefixime
  • Cefaclor
  • Cephalexin


The use of cephalosporins in the treatment of gonorrhea has already been recommended by the CDC in previous years for certain groups of individuals, such as men who have sex with men (MSM), in addition to those who have acquired the infection in California, Asia, or Pacific Islands, because of the increasing resistance to the fluoroquinolones.


Bacteria are able to mutate or change into forms that can survive despite the administration of drugs meant to kill or weaken them, meaning that over time, bacteria develop antibiotic resistance. The effective treatment of some conditions with antibiotics is made difficult due to the development of antibiotic resistance. Some of the conditions that are becoming more and more difficult to treat because of antibiotic resistance include gonorrhea, childhood ear infections, malaria and tuberculosis. The over-use of antibiotics and the increasing use of antibiotics in both humans and animals is believed to be the cause of the development of antibiotic resistance.


Prepared By: Dr. Mehyar Al-Khashroum
Edited By: Miss Araz Kahvedjian

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