Venereology
Gonorrhea
Information on Gonorrhea 
Gonorrhea, which is the second most common bacterial sexually transmitted disease in Europe, is due to the bacterium Neisseria gonorrhoeae, which is a Gram negative gonococcus. The gonococcus mainly infects the cylindrical epithelium of the urethra, the endotrachel, the congestive area, the pharynx and the conjunctivae. It is a disease that occurs equally in both men and women and is basically transmitted through sexual intercourse. However, women who are more easily affected by the bacteria than men are at greater risk of infection. According to medical research, a man who has sex with a woman who is a carrier of the virus has about 20% chance of getting the disease, while a woman who contacts a male viral carrier has about 50%.
 
Who Is Affected by Gonorrhea?
Gonorrhea is a global disease. It affects both sexes, especially sexually active adolescents and young adults, and the prevalence of the disease is higher in groups of low socio-economic level. In most industrialized countries, gonorrhea, like syphilis, has declined over the last 20 years. Since 1991, however, in the Eastern and Central European countries there has been a significant increase in occurrences, in a parallel upward trend with syphilis. In addition, chemotherapeutic drug-resistant strains of gonorrhea have grown worldwide, and this poses a significant problem in limiting and controlling gonococcal infections. In recent years, there has also been a slight increase in gonorrhea in our country between the ages of 17 and 24 and is mainly due to the non-use of a condom during sex.

Details of Gonorrhea
Although the infection usually remains locally restricted to the initial areas of infection, it may in some cases progress to the upper genital system and cause complications such as pelvic inflammatory disease and epididymorchitis or rarer bacteraemia. Transmission is by direct contact of infected mucosal secretions into mucosa during sexual intercourse, e.g. genital genital area, genital area with perioral area, oral genital area. It can also pass from mother to newborn at birth. Complications of gonorrhea include also joint and heart involvement even with gonococcal endocarditis. This is a particularly dangerous disease if left untreated. That is why we must immediately resort to a specialist and avoid practical treatments and doctors.

What Are The Symptoms Of Gonorrhea?
The symptoms and signs of gonococcal infection are basically caused by local inflammation of the infected mucosal surfaces of the genital area. In men asymptomatic infection is very rare. The majority of gonococcal infections in men are presented with symptoms of acute urethritis and especially mucopurial secretion in the urethra. In women, endocrine and urethral infection is induced, and symptoms include increased or altered consistency or color vaginal secretions, pain in urination and, more rarely, bleeding. Generally, however, endocervical infection is asymptomatic. If newborns are infected with gonorrhea, gonococcal ophthalmitis usually occurs and, as a result of their birth, a special anti-gonococcal solution is placed in their eyes. It is important to mention that in many individuals gonorrhea coexists with chlamydial or trichomoniasis infection, so thorough scrutiny should be done to properly diagnose any symptoms.

How Is The Diagnosis of Gonorrhea Performed?
Diagnosis of gonorrhea is performed by laboratory tests to identify Neisseria gonorrhoeae in samples from the genital, peri-royal, pharyngeal or ocular areas. The tests made for the best diagnosis are:
  • Immediate microscopic examination with Gram staining to reveal the Gram negative duplex.
  • Culturing endotracheal, urethral, rectal, pharyngeal or ocular exudates. It is the only test that offers the possibility of controlling susceptibility to antimicrobials, but it is inappropriate if the test sample is urine.
How Is Gonorrhea Treated?
The therapeutic options for gonococcal infection are continually limited by the ability of Neisseria gonorrhoeae to develop antimicrobial resistance. Previously, quinolones and cephalosporins were used to treat gonorrhea. However, in recent years they are not preferred because it has been found that most strains of the virus are resistant to these substances. Therefore, the most common treatment is the treatment with ceftriaxone and azithromycin, and it is recommended by doctors to monitor patients with gonorrhea and other sexually transmitted diseases that in many cases co-exist with gonorrhea. The sexual partners of patients with gonorrhea should also be treated. In any case, abstinence from sexual activity is recommended during treatment and until both partners are asymptomatic.
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