ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Gonorrhea: Health Relevance, Pathology And Clinical Manifestations

Updated on March 24, 2014

Gonorrheal Outgrowths In Mucous Membranes

Source

A General Overview Of Gonorrhea

Gonorrhea is one of the most common sexually transmitted diseases all over the world. This is caused by Neisseria gonorrhoeae, which is present throughout the world. Since several strains of N. gonorrhoeae have developed penicillin resistance due to the production of beta-lactamase, the disease increased in frequency and distribution. Due to altered sex practices, the manifestations have extended to several areas in the body.

Gonococci attach themselves to cells with the help of pilli before initiating infection. The organisms are ingested by polymorphs and they survive within the cells for variable periods, being protected from adverse environment. Four types can be distinguished by cultural characteristics, Types T1 and T2 are virulent whereas T3 and T4 are not.

Pathology: Gonococci affect columnar and transitional epithelium mainly and infection is initiated in the urethra, anal canal, conjunctiva, pharynx and endocervix. Pus is produced locally. Direct extension from the site of infection leads to complications such as endometritis, salpingitis, peritonitis and bartholinitis, in the female and periurethral abscess, epididymo-orchitis, and prostatitis in the male. Ocular conjunctiva is affected. Metastatic spread of the organisms leads to arthritis, dermatitis, endocarditis, meningitis, myopericarditis and hepatitis.

Gonorrheal Affection Of The Eye

Source

Clinical Presentations Of Gonorrhea

In the male, the onset of the disease is more smart and acute than in women. Incubation period is usually 3 to 5 days.

Gonorrhea in males: In over 90% of cases, urethritis presents with a constant burning sensation in the penis and discharge of infective pus which teems with the organisms. Meatal inflammation and penile edema may be obvious. Variable amounts of pus can be milked from the urethra. Micturition is painful and the patient is severely distress. Other adnexal structures like epidydimis, tests and spermatic cord become inflamed. Rarely, inflammation of the Tyson’s gland and the median raphe of the scrotum may develop. Gonococcal prostatitis and seminal vesiculitis are seen but they are rare. If left alone, the acute manifestations subside over a period of weeks or months even without treatment. Exacerbations occur frequently as a result of sexual indulgence, alcoholism or under exertion. Ultimately, the anterior and posterior urethra develop at times. Extension of suppuration into the periurethral tissues and scrotum result in fistulous openings discharging urine from multiple sites (“water-can scrotium”). In 10% of subjects, the lesion may be asymptomatic and has to be detected by examination.

The scrotum is an important site of ulceration in persons who are habitual catamites in homosexual relationship. The rectum and anal canal are ulcerated and show blood-stained mucopurulent discharge. The condition may present as proctitis and may be mistaken for other ulcerating lesions of this region.

Gonorrhea in the female: In a good number of women, gonerrhea may remain asymptomatic. Symptoms include leucorrhea, dysuria, pelvic inflammation. Rectal lesions develop in about 40% of affected women due to contamination by cervical discharges.

The gonococci may pass up from the endocervix leading to acute salpingitis and oophori-ovarian masses may develop. Exacerbations weeks thereafter. Gonococcal salpingo-oophoritis is a common cause of sterility.

Gonococcal Infection In the newborn:Inoculation of gonococci into the baby’s eyes from the maternal genital passages leads to ophthalmia neonatorium. This presents with purulent conjunctivitis which may result in blindness. The infection can also disseminate to other tissues and result in arthritis in the newborn.

Disseminated gonococcal infection: This occurs in up to 30% of infected patients. 80% of them being females. Bacteremic spread occurs. Manifestations include cutaneous lesions, septic arthritis, septicemia, endocarditis, myocarditis and rarely, pericarditis and meningitis. Risk of dissemination depends on the type and virulence of the organism. Dissemination is more common from silent foci in the pharynx, rectum, or endocervix. The cutanoeus lesions take the form of vesicles and pustules which do not usually ulcerate.

Oropharyngeal infections: Pharyngitis and tonsillitis result from oral sex and may affect both sexes. In the majority of cases, symptoms are not severe enough to seek medical care. Strong clinical suspicion and microbiological investigations are required to make the diagnosis. Gonococcal pharyngitis may give rise to dissemination.

© 2014 Funom Theophilus Makama

Comments

    0 of 8192 characters used
    Post Comment

    No comments yet.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)