N. gonorrhoeae is a fastidious gram-negative intracellular diplococcus (1).
Presents as conj...
Sexual history
Number of partners; age of onset of sexual activity; STI history
New/recent change in sexual partners
Contact with commercial sex workers
Condom use
Menses and possibility o...
STI counseling and condom use
In children and adolescents, suspect sexual abuse.
Dual therapy no longer recommended (4)[A].
Quinolones are not recommended (2,5)[A].
I...
U.S. Preventive Services Task Force (USPSTF) (6)[A]
Screen all sexually active women 24 years of age and younger and in older women at increased...
A54.9 Gonococcal infection, unspecified
A54.03 Gonococcal cervicitis, unspecified
A54.31 Gonococcal conjunctivitis
A54.5 Gonococcal pharyngitis
A54.01 Gonococcal cystitis and urethritis, unspec...
Gonococcal antibiotic resistance is a significant clinical problem.
Treatment for uncomplicated gonorrhea should include two drugs, one of which is effective against chlamydia.
Screen pa...
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Fig. 17-10 Urethral discharge associated with gonorrhea. This discharge may vary in color and copiousness and is accompanied by burning during urination.
Fig. 17-10 Urethral discharge associated with gonorrhea. This discharge may vary in color and copiousness and is accompanied by burning du...
Chlamydial mucopurulent cervicitis.
<bold>FIG. 125.1.</bold> Skin lesions characteristic of septicemia due to <italic>Neisseria gonorrhoeae</bold>. A: Hemorrhagic spot 5 to 6 mm in diameter on the upper arm; the gray area 1 to 2 mm in diameter in the center indicates necrosis. B: Pustulovesicular lesion on the finger of the same patient; the necrotic center is evident as a gray area.
<bold>FIG. 125.1.</bold> Skin lesions characteristic of septicemia due to <italic>Neisseria gonorrhoeae</bold>. A:...
Disseminated gonorrhea: pustule with hemorrhagic base and necrotic center.
Laparoscopic view of acute pelvic inflammatory disease (PID).
Pyosalpinx and blunted fimbria associated with acute PID.
Pathogenesis of gonococcal infections. Neisseria gonorrhoea is a gram-negative diplococcus whose surface pili form a barrier against phagocytosis by neutrophils. The pili contain an IgA protease that digests IgA on the luminal surface of the mucous membranes of the urethra, endocervix, and fallopian tube, thereby facilitating attachment of gonococci. Gonococci cause endocervicitis, vaginitis, and salpingitis. In men, gonococci attached to the mucous membrane of the urethra cause urethritis ...
Pathogenesis of gonococcal infections. Neisseria gonorrhoea is a gram-negative diplococcus whose surface pili form a barrier against phago...
FIG. 11.50. Disseminated gonococcemia. Neisseria gonorrhoeae may disseminate from mucosal surfaces via the bloodstream and produce arthritis/arthralgia and a rash. The most characteristic lesion is the hemorrhagic vesicopustule seen in the web space of the teenage girl's hand. There is a pustule on the sole of her foot.
FIG. 11.50. Disseminated gonococcemia. Neisseria gonorrhoeae may disseminate from mucosal surfaces via the bloodstream and produce arthrit...
<bold>FIGURE 2-10.</bold> The illusion of depth when using scanning electron microscopy clearly reveals the corkscrew shape of cells of the syphilis-causing spirochete, <italic>Treponema pallidum</bold>.
<bold>FIGURE 2-10.</bold> The illusion of depth when using scanning electron microscopy clearly reveals the corkscrew shape of ...
<bold><italic>Figure 20-19</bold> Syphilitic aortitis in tertiary syphilis. A,</bold> The aortic root is dilated, so that the valve does not seal properly during diastole (regurgitation), and the valve leaflets are thickened because of chronic inflammation and scarring. <bold>B,</bold> Marked left ventricular dilation and hypertrophy caused by aortic regurgitation associated with dilation of aortic root.
<bold><italic>Figure 20-19</bold> Syphilitic aortitis in tertiary syphilis. A,</bold> The aortic root is dilated, s...
FIG. 9.16. A: Trichomonad in the vaginal discharge of a 17-year-old patient with gonococcal pelvic inflammatory disease. The flagellated protozoan is elliptical and somewhat larger than the adjacent polymorphonuclear leukocytes (2253 magnification). B: After suspension in saline solution for microscopy, trichomonads gradually become swollen and immobile. This balloon-shaped trichomonad is barely recognizable (2253 magnification).
FIG. 9.16. A: Trichomonad in the vaginal discharge of a 17-year-old patient with gonococcal pelvic inflammatory disease. The flagellated pr...
1.15. A: Hyperacute gonococcal conjunctivitis, with copious mucopurulent discharge and lid swelling.
1.17. Gram stain of a conjunctival smear from a patient with gonococcal conjunctivitis. Figure 1.15A reveals many polymorphonuclear cells and intracellular gram-negative diplococci.
1.17. Gram stain of a conjunctival smear from a patient with gonococcal conjunctivitis. Figure 1.15A reveals many polymorphonuclear cells a...
Gonococcal mucopurulent cervicitis.