Oct
08
2010
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GONORRHOEA – CLINICAL MANIFESTATIONS 2

Infection may ascend from endocervix to the upper genital tract causing endometritis, salpingitis and pelvic inflammatory disease. Late sequelae include tubo-ovarian abscess and peri-hepatitis (Fitz-Hugh-Curtis syndrome).

Urethritis in females may cause dysuria and frequency without much discharge and be misdiagnosed as cystitis.

Infection of one or both Bartholin’s glands just inside the vulva may result in local pain, swelling and tenderness.

Anorectal infection secondary to genital infection is common in females. Anal sex may result in anorectal infection in both males and females. Anorectal infection may be asymptomatic or may present as a mucopurulent anal discharge and anal discomfort, including discomfort on defaecation.
Oral sex may result in oropharyngeal infection which may be asymptomatic or present as sore throat or pain on swallowing.
Conjunctivitis may occur in neonates as a result of transmission from an infected mother during parturition. Gonococcal conjunctivitis may occur as a local outbreak in older children or adults due to close contact or autoinoculation in communities with high carrier rates of gonorrhoea and poor hygiene standards.
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Oct
08
2010
--

GONORRHOEA – CLINICAL MANIFESTATIONS

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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