The incubation period is usually 2 to 7 days but may be as short as 24 hours or as long as a month. In many patients infection is asymptomatic.

Classically gonococcal urethritis in males begins with urethral discomfort then dysuria and mucoid discharge followed by a yellow discharge which is at first turbid and then opaque and sufficiently profuse to stain the underclothes.

Without treatment, infection can spread to the posterior urethra causing pain, frequency, urgency and terminal haematuria. Further ascent can produce prostatitis and vesiculitis manifested by deep genital pain and tenderness on rectal palpation. Epididymitis may cause scrotal pain, tenderness and swelling which should not be confused with torsion of the testis. If gonococcal urethritis is not adequately treated, sequelae may include urethral stricture and chronic prostatitis or epididymitis.

Cervicitis is the commonest type of infection in females and is often asymptomatic. It may be associated with profuse discoloured vaginal discharge sometimes with vaginal or vulval irritation which may be misdiagnosed as a vulvovaginitis. In premcnarchal girls, gonococcal infection can cause a vulvovaginitis.
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