Name: Sammah, Jumer M.

Year and Set: BSN II-C

GONORRHEA

DESCRIPTION

Gonorrhea is an infection caused by a sexually transmitted infection (STI) that can infect both male and
females. Gonorrhea most often affects the urethra, rectum or throat. In females, gonorrhea can also
infect the cervix.

● It is common acute bacterial infection, transmitted by sexual contact or perinatally

● It is caused by infection called the Neisseria gonorrhoea bacterium

● Gonorrhea is very common, having been known for centuries by the slang term "the clap"

EPIDEMIOLOGY

● Population at greatest risk include 15-24 years old

● The incubation period is 1to 14 days, but usually 1 to 5 days

● Transmission from male to female in onse exposure is 50-70% whereas transmission from female to
male is 20%

● Recurrent infection is common

ROUTE OF TRANSMISSION

● Vaginal, anal and oral sex with someone who has gonorrhea, you can contact the disease

● During childbirth, a gonorrhea-infected pregnant mothers can pass the infection on to her infant. The
child most commonly suffers from ophthalmia neonatorum.
PATHOPHYSIOLOGY

N. gonorrhea - a gram -ve bacteria having pili which protect from phagocytic of neutrophil and
IgA protease enzyme which digest the IgA that present in urethra, fallopian tube and endo
cervix allowing attachment to these surfaces.

Replicate and Grow at the Inflammatory

BACTERIA ( -ve)
site of infection Reaction

Fibrosis (Fibrotic
react)
Gonorrhoeal complications

SIGNS AND SYMPTOMS

In many cases, gonorrhea infection causes no symptoms. When symptoms do appear, gonorrhea
infection can affect multiple sites in your body, but it commonly appears in the genital tract.

Gonorrhea affecting the genital tract

Signs and symptoms of gonorrhea infection in men include:

● Painful urination

● White, yellow and greenish pus-like discharge from the tip of the penis

● Pain or swelling in one testicle

Signs and symptoms of gonorrhea infection in women include:

● Increased vaginal discharge

● Painful urination

● Vaginal bleeding between periods, such as after vaginal intercourse

● Abdominal pain

● Pelvic pain

Gonorrhea at other sites in the body

Gonorrhea can also affect these parts of the body:

Rectum. Signs and symptoms include Anal itching, pus-like discharge from the rectum, spots of bright
red blood on toilet tissue and having to strain during bowel movements.

Eyes. Gonorrhea that affects your eyes may cause eye pain, sensitivity to light, and pus-like discharge
from one or both eyes.

Throat. Signs and symptoms of a throat infection may include a Sore throat and Swollen lymph nodes in
the neck.

Joints. If one or more joints become infected by bacteria (Septic arthritis), the affected joints may be
warm, red, swollen and extremely painful, especially when you move an affected joint.

RISK FACTORS

Factors that may increase your risk of gonorrhea infection include:

● Younger age (mostly 15-24 years of age)

● Unprotected sex with an infected person

● Multiple sex partners

● Previous gonorrhea diagnosis

● Having other sexually transmitted infections

COMPLICATIONS
Untreated gonorrhea can lead to significant complications, such as:

Infertility in women. Untreated gonorrhea can spread into the uterus and fallopian tubes, causing Pelvic
inflammatory disease (PID), which may result in scarring of the tubes, greater risk of pregnancy
complications and Infertility. PID is a serious infection that requires immediate treatment.

Infertility in men. Men with untreated gonorrhea can experience Epididymitis — inflammation of a
small, coiled tube in the rear portion of the testicles where the sperm ducts are located (epididymis).
Epididymitis is treatable, but if left untreated, it may lead to Infertility.

Infection that spreads to the joints and other areas of your body. The bacterium that causes gonorrhea
can spread through the bloodstream and infect other parts of your body, including your joints. Fever,
rash, skin sores, joint pain, swelling and stiffness are possible results.

Increased risk of HIV/AIDS. Having gonorrhea makes you more susceptible to infection with human
immunodeficiency virus (HIV), the virus that leads to AIDS. People who have both gonorrhea and HIV are
able to pass both diseases more readily to their partners.

Complications in babies. Babies who contract gonorrhea from their mothers during birth can develop
blindness, sores on the scalp and infections.

TESTS AND DIAGNOSIS

To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a
sample of cells. Samples can be collected by:

Urine test. This may help identify bacteria in your urethra.

Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be
identified in a laboratory.

Gonococcal culture. These cultures attempt to grow the gonorrhea bacteria from swabs taken from sites
of potential infection. Cultures are the only tests that detect the infection’s susceptibility to antibiotics.
Doctors may order a gonococcal culture if they suspect you have an antibiotic-resistant strain of
gonorrhea.

Gram stain. This looks for certain types of cells that are characteristic of a gonorrhea infection under a
microscope. The test is performed on urethral swabs and is used primarily in men who are experiencing
urinary symptoms.

TREATMENTS AND DRUGS

Gonorrhea treatment in adults

● Adults with gonorrhea are treated with antibiotics. Due to emerging strains of drug-resistant Neisseria
gonorrhoeae, the Centers for Disease Control and Prevention recommends that uncomplicated
gonorrhea be treated only with the antibiotic ceftriaxone (Rocephin) — given as an injection — in
combination with either azithromycin (Zithromax, Zmax) or doxycycline (Monodox, Oracea,Vibramycin)
— two antibiotics that are taken orally.

● Some research indicates that oral gemifloxacin (Factive) or injectable gentamicin, combined with oral
azithromycin, is highly successful in treating gonorrhea. This treatment may be helpful in treating people
who are allergic to cephalosporin antibiotics, such as ceftriaxone.

Gonorrhea treatment for babies

Babies born to mothers with gonorrhea receive a medication in their eyes soon after birth to prevent
infection. If an eye infection develops, babies can be treated with antibiotics.

● Erythromycin ophthalmic ointment should be instilled into the bith eyes of neonates as soon as
possible after delivered vaginally or by cesarean delivery.

● If erythromycin ointment is unavailable can be administered ceftriaxone 25-50 mg/kg body weight
IM/IV not to exceed 250 mg in a single dose.

NURSING INTERVENTION/MANAGEMENT

1. Use standard precautions when obtaining specimens for laboratory examination and when caring for
the patient.

2. Isolate the patient with an eye infection.

3. If the patient has gonococcal arthritis, apply moist heat to ease the pain in the affected joints.

4. Before treatment, determine if the patient has any drug sensitivities.

5. Monitor the patient for complications.

6. Tell the patient that until cultures prove negative, he’s still infectious and should avoid unprotected
sexual contact.

7. Urge the patient to inform his sexual partners of his infection so that they can seek treatment.

8. Advise the partner of an infected person to receive treatment even if she doesn’t have positive
cultures.
9. Counsel the patient and his sexual partners to be tested for human immunodeficiency virus and
hepatitis B infection.

10. Instruct the patient to be careful when coming in contact with his bodily discharges so that he
doesn’t contaminate his eyes.

11. Tell the patient to take anti-infective drugs for the length of time prescribed.

12. To prevent reinfection, tell the patient to avoid sexual contact with anyone suspected of being
infected, to use condoms during intercourse, to wash genitalia with soap and water before and after
intercourse.

PREVENTION

Take steps to reduce your risk of gonorrhea:

Use a condom if you choose to have sex. Abstaining from sex is the surest way to prevent gonorrhea.
But if you choose to have sex, use a condom during any type of sexual contact, including anal sex, oral
sex or vaginal sex.

Ask your partner to be tested for sexually transmitted infections. Find out whether your partner has
been tested for sexually transmitted infections, including gonorrhea. If not, ask whether he or she would
be willing to be tested.

Don't have sex with someone who has any unusual symptoms. If your partner has signs or symptoms
of a sexually transmitted infection, such as burning during urination or a genital rash or sore, don't have
sex with that person.

Consider regular gonorrhea screening if you have an increased risk. Talk to your doctor about regular
gonorrhea screening if you have an increased risk of infection. You may be at increased risk of gonorrhea
if you have had gonorrhea or other sexually transmitted infections in the past, if you have a new sex
partner, or if you have multiple sex partners.