Gonorrhoea

Definition
Gonorrhoea is a sexually transmitted infectious disease caused by the bacterium Neisseria gonorrhoeae which mainly affects the mucous membranes of the urethra, cervix, rectum, pharynx or conjunctiva.
Causes / Etiology

Direct sexual contact with infected person through vaginal, anal or oral sex
Mother to child transmission during delivery causing ophthalmia neonatorum
Rarely through contaminated fingers or objects but organism dies quickly outside body

Uncomplicated gonorrhoea – affects lower genitourinary tract like urethra or cervix with only local symptoms
Complicated gonorrhoea – spreads to upper genital tract or distant sites causing pelvic inflammatory disease, epididymitis or disseminated infection with arthritis and skin lesions

Bacterium attaches to columnar epithelium of mucous membrane
Invades subepithelial tissue and causes acute inflammation
Polymorphs infiltrate and large pus formation occurs
In males causes anterior urethritis with purulent discharge
In females causes endocervicitis often asymptomatic
If untreated ascends to cause prostatitis or salpingitis
Rarely enters blood leading to disseminated infection with septic arthritis and dermatitis

Incubation period two to seven days
Burning micturition with thick yellow green purulent discharge
In males severe dysuria and urethral discharge
In females vaginal discharge, intermenstrual bleeding, dyspareunia but often asymptomatic
Rectal infection gives anal pain and discharge
Pharyngeal infection causes sore throat
Newborn shows purulent conjunctivitis with lid swelling
Disseminated form shows migratory polyarthritis, tenosynovitis and pustular skin lesions

Acute – epididymitis, prostatic abscess in males; Bartholin abscess, pelvic inflammatory disease in females
Chronic – urethral stricture, infertility from tubal blockage, chronic pelvic pain
Disseminated – septic arthritis, endocarditis, meningitis (rare but serious)

Partner notification and simultaneous treatment
Abstinence from sex till both cured
Condom use for future prevention
Modern treatment – single dose ceftriaxone IM plus azithromycin oral (dual therapy)
Alternative for allergy – spectinomycin or gemifloxacin
Plenty of fluids intake
Avoid alcohol and spicy food as they irritate urethra

Thuja occidentalis

Cannabis sativa

Nitric acid

Mercurius solubilis