Gonorrhea Case Study: Diagnosis and Sample Collection

Complications of Pelvic Inflammatory Disease (PID)

• PID is an ascending infection that can cause inflammation in the uterus, fallopian tubes, and ovaries.
• Inflammation of the uterine lining is called endometritis, while inflammation of the fallopian tubes is called salpingitis.
• If the infection spreads to the ovaries, it can cause peritonitis, an inflammation of the pelvic cavity.

Ectopic Pregnancy and Infertility

• PID can lead to ectopic pregnancy, where the egg develops in the fallopian tube instead of the uterus.
• Damage to the fallopian tube can cause infertility.
• In 3 months, the patient may feel pressure and the fallopian tube can rupture.

Tubo-Ovarian Abscess

• A tubo-ovarian abscess is a complication of PID that can cause further damage to the reproductive organs.

Gonorrhoea Complications

• Gonorrhoea can cause conjunctivitis, an infection of the eye, which can lead to blindness if left untreated.
• Infection of the eye can also cause keratitis, an infection of the cornea.
• Ophthalmia neonatorum is a condition where a newborn baby contracts gonorrhoea from the mother during delivery, leading to blindness.

Disseminated Gonococcal Infection (DGI)

• DGI is a complication of gonorrhoea that can cause septic arthritis, a bacterial infection of the joints.
• DGI can be caused by staph aureus.

Gonorrhoea Diagnosis

• Gram stain is used to diagnose gonorrhoea, showing 3+ organism.
• Material outside of gonorrhoea is good at preventing the death of the organism inside a polymorph.
• Selective agar is used to grow the organism, and chocolate agar is used to prevent overgrowth.

Gonorrhoea Infections

• In males, gonorrhoea is characterized by 3+ intracellular gram-negative diplococci.
• In females, gonorrhoea is characterized by 1+ polymorphs and skin-type rods.

Pathogenicity

• Adhesion with fimbriae is a key factor in the pathogenicity of gonorrhoea.
• A mutation in the gene that codes for fimbriae can affect the pathogenicity of the organism.

Case Study

• A male patient with purulent urethral discharge, sore throat, dysuria, and swollen testicles may have gonorrhoea.
• The patient's symptoms may be caused by oral sex, and the discharge may mask the presence of chlamydia.
• The clinician should collect a swab of the pus and place it in transport media, and transport it quickly to the lab for testing.
• PCR may be used to diagnose gonorrhoea, but only for known resistance.

Female Clinical Findings

• Gonorrhoea and chlamydia are often found at the back of the cervix, where they grow on a different type of epithelium.
• In females, gonorrhoea may cause little in the way of symptoms, but may cause inflammation on the cervix.
• When symptoms do occur, they may include urethritis, dysuria, vaginal discharge, lower abdominal pain, and anal itching.

A case study on a male patient with symptoms of gonorrhea, including purulent urethral discharge, sore throat, and swollen testicles. The quiz tests your knowledge on the diagnosis and sample collection procedures for this sexually transmitted infection.