Gonococcal Infections Lecture by Professor D

Introduction

• Gonococcal infections (Gonorrhea)
• Transmission: sexual fluids (vaginal, anal, oral sex)
  • Ejaculation not required
• Often co-tested with chlamydia due to common co-infection
• No immunity after infection and treatment
  • Can be repeatedly infected

Clinical Manifestations

• Men:
  • Common Symptoms:
    • Dysuria
    • Purulent urethral discharge
    • Epididymitis
• Women:
  • Often asymptomatic
  • Common Symptoms (if symptomatic):
    • Increased vaginal discharge
    • Dysuria
    • Frequency of urination
    • Bleeding after sex
    • Redness and swelling at cervix/urethra

Complications

• Men:
  • Epididymitis (possible infertility)
• Women:
  • Infection in Bartholin's glands
  • Pelvic Inflammatory Disease (PID), leading to:
    • Ectopic pregnancies
    • Infertility
    • Serious pain
• Neonates:
  • Gonococcal conjunctivitis (transmitted during delivery)
  • Antibiotic ointment in the eye mandatory in most states for infected mothers

Diagnostic Studies

• Men:
  • Presume diagnosis if history of sexual contact with infected/new partner and symptoms
  • NAAT (Nucleic Acid Amplification Test) commonly used
  • Can also use urinalysis or culture

Interprofessional Care

• First-line Treatment:
  • IM with oral azithromycin
• Sexual Contacts:
  • Must be evaluated and treated
  • Infection must be reported to the state
  • Abstain from sexual intercourse during and one week after treatment
• Patient Education:
  • Use barrier methods (condoms)
  • Review STI risk reduction

Gender Differences in STIs

• Men:
  • Higher incidence in men who have sex with men (MSM)
  • More pronounced symptoms
  • Less complex anatomy makes infections easier to diagnose
  • Reluctance to seek medical care unless symptoms affect genital area
• Women:
  • Higher risk due to complex anatomy
  • More frequent and severe complications
  • Higher chance of chlamydia infection
  • Common infections: gonorrhea, trichomoniasis, herpes (HSV-1, HSV-2)
  • HPV most common STI
• Important Complications (NCLEX):
  • PID, infertility, ectopic pregnancy, untreated syphilis (fatal in severe cases)
  • Infant death from untreated syphilis in pregnant women

Conclusion

• Plans to create an STI series including HIV
• Encouragement to check out website and social media for more content on nursing topics