Gonorrhea: Causes and Symptoms

Gonorrhea

• Gonorrhea is a sexually transmitted disease (STD) caused by Neisseria gonorrhea (Gonococcus) and is considered one of the most common STDs.
• It is a strictly human infection.

Clinical Manifestations

Females

• Gonorrhea infects both the urinary and genital tracts, causing urethritis and cervicitis.
• Symptoms include mucopurulent (or bloody) vaginal discharge, lower abdominal pain, and dysuria.
• Infection can ascend to the upper part of the female reproductive system, causing pelvic inflammatory disease (PID).
• PID can lead to infertility or ectopic pregnancies due to the buildup of scar tissue.

Males

• Gonorrhea mainly causes urethritis, characterized by dysuria and a yellowish discharge.
• Infection can ascend to cause prostatitis, epididymitis, and orchitis.
• Scar tissue formed in the spermatic ducts during healing of an invasive infection can render a man infertile.

Neonates

• Children born to gonococcus carriers can be infected as they pass through the birth canal.
• Gonococcal infection in neonates can cause ophthalmia neonatorum.

Treatment

• A 3rd generation cephalosporins (ceftriaxone, IM) in combination with azithromycin is recommended to treat gonococci and chlamydia associated with it.
• This is due to increasing resistance to other treatments.

Syphilis

• Caused by the bacterium Treponema pallidum, a Gram-negative spirochete
• Transmitted through sexual contact, saliva, and vertically from mother to child
• Creates a hazard for dentists due to potential transmission through saliva

Clinical Stages

• Untreated syphilis progresses through distinct clinical stages: primary, secondary, and tertiary syphilis
• Latent periods of varying duration occur between each stage
• Syphilis is nicknamed the "great imitator" due to its ability to mimic symptoms of other diseases

Primary Syphilis

• Characterized by the appearance of a chancre, a hard, painless ulcer on the genitals, lips, or fingers

Secondary Syphilis

• Copper-colored rash appears on the palms of hands and feet
• Painful whitish mucous patches (containing spirochetes) appear on the tongue, cheeks, and gums
• Spread through kissing

Tertiary Syphilis

• Cardiovascular syphilis: damage and calcification of heart valves and blood vessels
• Neurosyphilis: thickening of meninges, ataxia, paralysis, and insanity

Treatment

• Penicillin G is the drug of choice for treating syphilis
• Alternative treatments include macrolides or tetracyclines