Gonorrhea aetiology:
A. Causative organism: gonococci (gram –ve intracellular diplococci).
B. Mode of infection:
1) Sexual route: sexual intercourse (the most important).
2) Non-sexual routes:
• Contaminated towels & instruments.
• Ophthalmia neonatorum (passage through infected birth canal).
C. Predisposing factors: multiple sexual partners.
Sites of infection: (tissues not covered by stratified squamous epithelium)
A. Primary sites: urethra, Skene’s glands, Bartholin’s glands & endocervical glands.
B. Secondary sites: tubes & ovaries + pelvic peritoneum, endometrium, UB & kidney.
C. Tertiary sites: disseminated gonococcal infection e.g. iridocyclitis.
N.B. Adult vagina is protected by its thick mucosa (squamous epithelium) & acidic pH.

Gonorrhea diagnosis:
(Incubation period= 2- 8 days).
Acute gonorrhea:
1) Urethritis: urethral discharge can be milked from the external urethral meatus.
2) Skenitis.
3) Vulvovaginitis: in children.
4) Bartholinitis: as before.
5) Endocervicitis.
6) Acute PID: Discharge mucopurulent green-yellowish offensive discharge.
7) Rectal affection (proctitis).
8) Tonsillitis and pharyngitis.
9) Gonococcal septicemia, Pyrexia and may be pustular dermatitis.
10) Fitz- Hugh- Curtis syndrome. See before.
Chronic gonorrhea:
1) Infertility.
2) Bartholin cyst: see later.
3) Chronic endocervicitis.
Gonorrhea investigations:
Acute gonorrhea: culture on Thayer-Martin medium.
Chronic gonorrhea: Serological tests to detect gonococcal antibodies.
Gonorrhea treatment:
A. Prophylactic treatment: prevention of STD.
B. Active treatment:
* For mother:
a) Acute gonorrhea:
– Procaine penicillin+ oral Probencid.
– Ceftriaxone + doxycycline.
b) Chronic gonorrhea:
– Penicillin in large doses over long period & repeated courses.
– Treatment of residual lesions: e.g. marsupilization for Bartholin’s cyst.
* For neonate: local penicillin eye drops & systemic antibiotics.
Gonorrhea videos:
Drug-Resistant Gonorrhea: An Urgent Public Health Issue video
This animation details the history of drug-resistant gonorrhea in the United States, the dangers of untreatable gonorrhea, and why this issue must remain a top public health priority.
What is gonorrhea? | Infectious diseases | NCLEX-RN | Khan Academy video
Gonorrhea: Signs & Symptoms – Infectious Diseases | Lecturio video
► LEARN ABOUT: – Clinical picture of Gonorrhea – Types of gonorrhea – Gonorrhea and non-gonococcal urethritis
► THE PROF: Your tutor is Dr. John Fisher, who is certified by the American Board of Internal Medicine in both Medicine and Infectious Diseases. In his 30 years on the faculty of the Medical College of Georgia he has received multiple awards for his excellent teaching. Dr. Fisher is also the author of 61 original publications in refereed journals and 44 book chapters.
► LECTURIO is your single-point resource for medical school: Study for your classes, USMLE Step 1, USMLE Step 2, MCAT or MBBS with video lectures by world-class professors, recall & USMLE-style questions and textbook articles.
Pathophysiology, diagnosis, treatment, and prevention of gonorrhea | NCLEX-RN | Khan Academy video
Gonorrhea PPT (power point presentations):
Gonorrhoea Update PPT
Scientific Presentation on Gonorrhoea Speaker: Dr. Md. Shahidul Islam Assistant Professor of Dermatology & VD, CBMC’B Chairperson: Professor. Hasibur Rahman Head of the Department of Dermatology & VD, CBMC’B