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Gonococcal Disease, Emergency Medicine

Sunil D. Shroff Reviewed 06/2017



  • 2nd most frequently reported STD in US:

    • Estimated 820,000 new cases per year

    • <50% reported

    • Highest rates in 15–24-yr-old males and females, African Americans

    • Increasing incidence in m...


Signs and Symptoms

  • Cervicitis:

    • Defined as:

      • Mucopurulent endocervical discharge; OR

      • Easily induced endocervical bleeding

    • Most common site of infection

    • Up to 80% asymptomatic

    • Most symptoms nonspecifi...


Ed Treatment/Procedures

  • Hydration (0.9% NS) for nausea/vomiting

  • Treat sexual partner. For expedited partner therapy jurisdiction –

  • Patient with gonorrhea should often be pre...



Admission Criteria

PID—CDC recommendations 
  • Severely ill (e.g., nausea, vomiting, and high fever)

  • Pregnant

  • Does not respond to or cannot take oral medication

  • Tubo-ovarian abscess

  • Other ...

Pearls and Pitfalls

  • Epididymitis—rule out torsion

  • DGI—strongly consider in young sexually active patient with acute nontraumatic oligoarthritis or tenosynovitis

Additional Reading

  • American Academy of Pediatrics. Gonococcal infections. In: Pickering  LK, Baker  CJ, Kimberlin  DW, Long  SS, eds. Red Book: 2012 Report of the Committee on Infectious Diseases. El...



  • 098.0 Gonococcal infection (acute) of lower genitourinary tract

  • 098.7 Gonococcal infection of anus and rectum

  • 098.15 Gonococcal cervicitis (acute)

  • 098.11 Gonococcal cystitis (acute)

  • 098.10 Gonoc...

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