Gonorrhea Lecture Notes

Overview

• Gonorrhea, also known as "the clap," is a sexually transmitted infection (STI).
• Caused by the bacterium Neisseria gonorrhoeae.
• Affects the genitals, mouth, or rectum.

Symptoms

• Men:
  • Burning sensation during urination.
  • Discharge from the penis.
  • Testicular pain.
• Women:
  • Burning with urination.
  • Vaginal discharge.
  • Vaginal bleeding between periods.
  • Pelvic pain.
  • 50% of women may be asymptomatic.
• Infants:
  • Gonococcal ophthalmia neonatorum (eye infection).

Complications

• Women:
  • Pelvic inflammatory disease (PID), which can cause infertility.
• Men:
  • Epididymitis, leading to infertility.
• General:
  • Spread to joints, skin, and heart valves.
  • Increased risk of HIV/AIDS.
  • Complications in infants can lead to blindness.

Transmission

• Transmitted through sexual contact.
• From mother to child during childbirth.
• High risk in sexually active women under 25 and men who have sex with men (MSM).

Diagnosis

• Testing urine, urethral swabs in males, and cervical/vaginal swabs in females.
• PCR-based testing recommended.
• Culture and Gram-stain for throat, rectum, eyes, blood, or joints.

Prevention

• Correct use of condoms.
• Having sex with only one uninfected partner.
• Abstinence.
• Screening recommended for at-risk groups.

Treatment

• Antibiotics:
  • Ceftriaxone by injection.
  • Azithromycin by mouth.
• Resistance to antibiotics is increasing.
• Ertapenem as an alternative for resistant cases.

Antibiotic Resistance

• High rates of resistance to older antibiotics like penicillin.
• Global concern about emerging resistant strains.

Epidemiology

• Approximately 88 million cases annually worldwide.
• Higher prevalence in Africa, Americas, and Western Pacific.
• WHO warns of untreatable strains.

Historical Context

• Previously treated with mercury, silver nitrate, and Protargol.
• The term "the clap" possibly originated from Paris’s red-light district.

Research and Future Directions

• Vaccine development underway, promising studies on cross-protection from meningococcal vaccines.
  • GSK's vaccine candidate received FDA fast-track status.

These notes cover the essential aspects of gonorrhea, including its symptoms, diagnosis, prevention, and treatment strategies, as well as ongoing challenges with antibiotic resistance and efforts in vaccine development.