Gonorrhea

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Gonorrhea (also gonorrhoea) is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae (also called Gonococcus, which is often abbreviated as "GC" by clinicians). In the US, its incidence is second^[1] only to chlamydia among bacterial STDs.^[2] In both men and women if gonorrhea is left untreated, it may spread throughout the body, affecting joints and even heart valves.
Gonorrhea cannot be caused by sharing toilets and bathrooms. ^[3]

Signs and symptoms

Gonorrhea is caused by the Neisseria gonorrhoeae bacteria. The infection is transmitted from one person to another through vaginal, oral, or anal sexual relations, though transmission occurs rarely with safe sex practices of condom usage with lubrication. The incubation period is 2 to 30^[4] days with most symptoms occurring between 4–6 days after being infected. A small number of people may be asymptomatic for a lifetime. Between 30% and 60% of people with gonorrhea are asymptomatic or have subclinical disease.^[5]
In males, symptoms include a yellowish discharge from the penis, associated with painful, and sometimes frequent, urination. Symptoms can develop from two to thirty days after infection. A few percent of infected men have no symptoms. The infection may move into the prostate, seminal vesicles, and epididymis, causing pain and fever. Untreated, gonorrhea can lead to sterility. It is not unusual for men to have asymptomatic gonorrhea. Men may complain of pain on urinating and thick, copious, urethral pus discharge (also known as gleet) is the most common presentation. Examination may show a reddened external urethral meatus. Ascending infection may involve the epididymis, testicles or prostate gland causing symptoms such as scrotal pain or swelling.
Fewer than half the women with gonorrhea show any symptoms, or symptoms mild enough to be ignored. Women may complain of vaginal discharge, difficulty urinating (dysuria), projectile urination, off-cycle menstrual bleeding, or bleeding after sexual intercourse. The cervix may appear anywhere from normal to the extreme of marked cervical inflammation with pus. Early symptoms may include a discharge from the vagina, discomfort in the lower abdomen, irritation of the genitals, pain or burning during urination and abnormal bleeding. Less advanced symptoms, which may indicate development of pelvic inflammatory disease (PID), include cramps and pain, bleeding between menstrual periods, vomiting, or fever. Women who leave these symptoms untreated may develop severe complications. The infection will usually spread to the uterus, fallopian tubes, and ovaries, causing Pelvic Inflammatory Disease (PID).
Possibility of increased production of male hormones is common. Infection of the urethra (urethritis) causes little dysuria or pus. The combination of urethritis and cervicitis on examination strongly supports a gonorrhea diagnosis, as both sites are infected in most gonorrhea patients. Gonorrhea infection can also be present as septic arthritis. Instances of blurred vision in one eye may occur in adults.
Men have a 20% risk of getting the infection from a single act of vaginal intercourse with a woman infected with gonorrhea. Women have a 60-80% risk of getting the infection from a single act of vaginal intercourse with a man infected with gonorrhea.^[6] An infected mother may transmit gonorrhea to her newborn during childbirth, a condition known as ophthalmia neonatorum.^[7]