Gonorrhea

Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It commonly infects mucous membranes of the genitourinary tract, but can also affect the pharynx, rectum, and, in newborns, the eyes. Transmission occurs through sexual contact and, during birth, from mother to child.

Many infections do not cause symptoms. In men, possible signs include urethral discharge and burning during urination. In women, cervicitis with vaginal discharge, intermenstrual bleeding, or pelvic pain may occur. Pharyngeal and rectal infections can be asymptomatic or cause throat or rectal discomfort. In some cases, the infection spreads through the body, leading to disseminated gonococcal infection with arthritis, tendon inflammation, and skin lesions.

Complications can be serious. In women, untreated infection may cause pelvic inflammatory disease, infertility, or an increased risk of ectopic pregnancy. In men, epididymitis can occur. Neonates risk neonatal conjunctivitis during birth. The infection also increases the risk of acquiring or transmitting HIV.

Diagnosis relies on laboratory testing. Nucleic acid amplification tests on urine or swabs from the affected sites are commonly used. Cultures with antibiotic susceptibility testing are important in some settings. People diagnosed with gonorrhea should be tested for other sexually transmitted infections, and sex partners from the previous weeks should be notified and treated if appropriate.

Treatment typically involves dual therapy with a cephalosporin, such as ceftriaxone, combined with another antibiotic (often doxycycline) to cover possible chlamydia coinfection. Due to rising resistance, treatment guidelines vary by region and emphasize antimicrobial stewardship and partner management.

Prevention focuses on consistent condom use, regular screening for at-risk groups, and prompt treatment of cases and partners. There is currently no approved vaccine for gonorrhea.