Gonorrhea is the commonest cause of sexually transmitted infection (ST l). It is caused by the Gram-negative intracellular bacillus N. gonorrhoeae. It presents with a painful acute urethritis that causes a purulent discharge from the urethra (shown in Fig. Below).
Gonorrhea. A painful purulent urethral discharge.
This is more obvious in males than in females. In fact, infection may not be noticed by the female and acute salpingitis may develop: this condition may progress to chronic salpingitis and may cause infertility. Patients with gonorrhea may develop an acute arthritisof large joints (such as the knees), due to a systemic bacteremia, or the arthritis may result from an autoimmune reaction.
Babies delivered through a vagina infected with thegonococcus often get an acute ophthalmitis—gonococcal ophthalmitis (see Fig. below).
Neonatal gonococcal ophthalimitis.
Gram stain of the purulent exudate shows the Gram-negative diplococci of N. gonorrhoeae (see Fig. below).
Gram stain on the purulent exudate shows the Gram-negative intracellular diplococci of N. gonorrhoeae.
Cultureon chocolate agar confirms the presence of the organism, as illustrated in Figures ‘a’ and ‘b’.
(a). Chocolate agar culture plate showing the colonies of N. gonorrhoeae.
(b). Chocolate agar culture plate. A drop of oxidase solution has been dropped onto some of the N. gonorrhoeae colonies and the colonies have turned blue. Adjacent colonies have not been treated so as to provide a control appearance. This test is specific for N. gonorrhoeae.