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Gonorrhea is a sexually transmitted infection (STI) that may be detected on regular visits at the local sexual health or genitourinary medicine (GUM) clinic for a sexual health test. It is a treatable infection.
Early diagnosis and detection of gonorrhoea is important since it may cause long term complications in both men and women. Further early infections are easier to treat using antibiotics but later complications are more difficult to treat.
Since almost half of infected women and around one in 10 men do not show any symptoms but may be transmitting the infection to their sexual partners and possibly new born babies, it is important that those at risk get tested regularly.
For detection, a swab is used to collect samples of the discharge from the cervix or vagina of the tested woman. In men a swab is used to collect a sample from the entrance of the urethra or they may be asked to provide a urine sample. Those with suspected infections elsewhere need to be tested from their rectum or throat. Those with conjunctivitis are examined and samples of their eye discharge are taken.
Rapid detection tests include the positive nucleic acid amplification test (NAAT) for gonococcus.
Tests can be performed at the genitourinary medicine (GUM) or sexual health clinic, at the general practitioner’s office, at a contraceptive and young people’s clinic or a private clinic.
It is important to receive treatment for gonorrhoea quickly. The infection rarely goes away without treatment. Those who delay treatment increase their risk of complications and this may lead to more serious health problems. Also an infected person can transmit the infection to others.
Gonorrhoea is treated with a single dose of antibiotics, usually one of the following:
Gonorrhoea has become resistant to penicillins and thus these are not commonly used in treatment. Those with symptoms of gonorrhoea may be given initial antibiotic therapy before the results of the tests come in.
Sexual partners of an infected person is also tested and offered treatment. Both individuals are advised to avoid sexual intercourse and intimate contact with other partners until they have completed the course of treatment. This is to prevent reinfection or passing the infection onto anyone else.
Those with severe, more widely spread gonococcal infections or those with complications of gonorrhoea may need hospital admission for treatment.
Babies with ophthalmia neonatarum or eye infections with gonococcus at birth will usually be given antibiotics immediately after birth. This is to prevent blindness and other complications.
For gonococcal conjunctivitis Ceftriaxone 500 mg IM daily for 3 days is prescribed. If there is history of penicillin allergy spectinomycin 2 g IM daily for 3 days or azithromycin 2 g orally stat plus doxycycline 100 mg twice daily for 1 week plus ciprofloxacin 250 mg daily for 3 days may be prescribed.
Most patients recover fully after taking antibiotics. Most of them show improvement in the pain and urethral or vaginal discharge in a day or two. Pain and discharge from rectum also eases in two to three days. Bleeding between periods usually improved before onset of next periods. Pain in the lower abdomen, testicles or epididymis start to improve quickly but could take up to two weeks to go away.
In 95% cases treatment is effective. Some patients may need to visit the clinic again for a follow up visit. This is needed if the signs and symptoms do not go away, patient has had unprotected sex with their partner in the week following treatment, patients feels they may have contracted the disease again or has gonorrhoea of the throat.