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Labs and Tests. Differential Diagnoses. At-Home Testing. If You Test Positive. Who Needs Screening? Next in Gonorrhea Guide. Gonorrhea Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF. Email the Guide Send to yourself or a loved one. Sign Up.
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Issued September Related Articles. Urine Testing for Sexually Transmitted Diseases. Sexually Transmitted Infection: Overview and More. Urine or Swab Tests. Chlamydia in Throat: Symptoms, Causes, Pictures. Diagnosis and Treatment of Mycoplasma Genitalium.
Rectal infection also may be asymptomatic. Pharyngeal infection may cause a sore throat, but usually is asymptomatic 11 , In women, gonorrhea can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease PID. The symptoms may be quite mild or can be very severe and can include abdominal pain and fever PID can lead to internal abscesses and chronic pelvic pain.
PID can also damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy. In men, gonorrhea may be complicated by epididymitis. In rare cases, this may lead to infertility If left untreated, gonorrhea can also spread to the blood and cause disseminated gonococcal infection DGI. This condition can be life threatening. If a pregnant woman has gonorrhea, she may give the infection to her baby as the baby passes through the birth canal during delivery.
This can cause blindness, joint infection, or a life-threatening blood infection in the baby Treatment of gonorrhea as soon as it is detected in pregnant women will reduce the risk of these complications. Pregnant women should consult a health care provider for appropriate examination, testing, and treatment, as necessary. Anyone with genital symptoms such as discharge, burning during urination, unusual sores, or rash should stop having sex and see a health care provider immediately.
Also, anyone with an oral, anal, or vaginal sex partner who has been recently diagnosed with an STD should see a health care provider for evaluation. Some people should be tested screened for gonorrhea even if they do not have symptoms or know of a sex partner who has gonorrhea Anyone who is sexually active should discuss his or her risk factors with a health care provider and ask whether he or she should be tested for gonorrhea or other STDs.
CDC recommends yearly gonorrhea screening for all sexually active women younger than 25 years, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection. Urogenital gonorrhea can be diagnosed by testing urine, urethral for men , or endocervical or vaginal for women specimens using nucleic acid amplification testing NAAT It can also be diagnosed using gonorrhea culture, which requires endocervical or urethral swab specimens.
FDA-cleared rectal and oral diagnostic tests for gonorrhea as well as chlamydia have been validated for clinical use Gonorrhea can be cured with the right treatment. CDC now recommends a single mg intramuscular dose of ceftriaxone for the treatment of gonorrhea. Alternative regimens are available when ceftriaxone cannot be used to treat urogenital or rectal gonorrhea. Although medication will stop the infection, it will not repair any permanent damage done by the disease.
Antimicrobial resistance in gonorrhea is of increasing concern, and successful treatment of gonorrhea is becoming more difficult A test-of-cure is needed days after treatment for people who are treated for pharyngeal infection of the throat gonorrhea.
Because re-infection is common, men and women with gonorrhea should be retested three months after treatment of the initial infection, regardless of whether they believe that their sex partners were successfully treated. If a person has been diagnosed and treated for gonorrhea, he or she should tell all recent anal, vaginal, or oral sex partners so they can see a health provider and be treated A person with gonorrhea and all of his or her sex partners must avoid having sex until they have completed their treatment for gonorrhea and until they no longer have symptoms.
Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea Most cases of pharyngeal infection will spontaneously resolve with no treatment and usually do not cause adverse sequelae. Treatment should be initiated, however, to reduce the potential for spreading the infection. There are two distinct categories of gonococcal infections in children. During the neonatal period and the first year of life, gonorrhea infections can cause neonatal conjunctivitis ophthalmia neonatorum ; pharyngitis; rectal infections; and, in rare cases, pneumonia.
These infections most commonly develop within two to five days after birth, because the neonate is exposed to infected cervical exudates during delivery.
Almost all new gonococcal infections in children older than one year are caused by sexual abuse. However, identifying and treating gonorrhea-related ophthalmia neonatorum is important because, if left untreated, it can cause perforation of the globe of the eye and blindness. Infants at risk of gonococcal conjunctivitis are those who did not receive prophylaxis for ophthalmia neonatorum, those whose mothers had no prenatal care, and those whose mothers have a history of STDs or substance abuse.
Common findings include inflammation of the conjunctiva and mucopurulent discharge from the eye. Testing neonates who have ophthalmia neonatorum for N. If intracellular gram-negative diplococci are present, N. Gonococcal cultures should confirm the diagnosis. Preadolescent children most commonly contract gonococcal infections through sexual abuse. Pharyngeal and rectal infections also may be present, but they are usually asymptomatic.
A culture method should be used to test children for N. Food and Drug Administration has not approved them for use in children. Specimens from the vagina, pharynx, urethra, or rectum should be used to isolate N. Disseminated infection is rare but can occur 1 to 3 percent of adults who have gonorrhea Septic emboli can cause polyarticular tenosynovitis and dermatitis in these patients. Patients with disseminated gonorrhea usually have no urogenital symptoms. The skin lesions typically are few and are limited to the extremities; they start as papules and progress into hemorrhagic pustules.
Bullae, petechiae, or necrotic lesions also may be present. The skin lesions usually are resolved if the gonorrhea continues to disseminate. Skin lesions and blood cultures usually are negative for N.
The joints most commonly affected by disseminated gonorrhea are the wrists, ankles, and the joints of the hands and feet. The axial skeleton rarely is involved. Initial aspiration of the joint may be negative for infection. If untreated, however, the patient will develop septic arthritis, which will most likely involve elbows, wrists, knees, or ankles.
Fluid cultures usually do not grow the organism. Disseminated gonorrhea also may present as bacterial endocarditis, meningitis, and myocarditis, although the incidences of these presentations have declined with the advent of antibiotic therapy. The CDC's treatment guidelines for uncomplicated gonococcal infections are included in Table 2. Therefore, the CDC advises against using f luoroquinolones to treat gonorrhea infection in patients who live or may have acquired infection in Asia, the Pacific islands including Hawaii , and California.
PID can be treated on an outpatient basis if the patient does not meet hospitalization criteria Table 3. Doxycycline is best administered orally because intravenous doxycycline can be painful and can adversely affect veins.
Cefoxitin, single 2-g dose IM administered concurrently with probenecid Benemid , single 1-g dose orally. Duration of oral regimens is 14 days. Pharyngeal gonococcal infections are more difficult to treat than urogenital or anorectal infections because few antibiotic regimens can reliably cure this infection. The CDC recommends ceftriaxone in a single mg dose intramuscularly or ciprofloxacin Cipro in a single mg dose orally, because these regimens have been shown to effectively treat pharyngeal gonorrhea.
Children with ophthalmia neonatorum or suspected gonococcal infection should be treated with ceftriaxone in a single or mg per kg dose intravenously or intra-muscularly. Fluoroquinolones should be avoided in children who weigh less than 99 lb 45 kg , because they are at risk of articular cartilage damage. Patients with suspected disseminated gonococcal infection should be hospitalized initially.
The CDC recommends ceftriaxone, 1 g intravenously or intramuscularly every 24 hours, for patients with disseminated infections. Fluoroquinolones and tetracyclines are contraindicated for pregnant women. Both of these regimens have similar cure rates. Ten to 30 percent of patients with gonorrhea will have a concomitant chlamydia infection; therefore, many experts advocate empirically treating chlamydia when treating patients with gonorrhea.
In one study 11 of an emergency department, compliance ranged from 14 to 79 percent with respect to history taking, physical examination, diagnostic testing, treatment, and counseling about safe sex. Less than one third of patients included in this study received CDC-recommended antibiotics. According to the CDC, all sexually active women younger than 25 years should be screened annually for gonorrhea.
Women 25 years of age or older should be screened annually if they have a new sexual partner or a history of multiple partners.
Preventive Services Task Force USPSTF recommends that all sexually active women, including those who are pregnant, receive routine screening if they are at increased risk of infection. Already a member or subscriber? Log in. Interested in AAFP membership? You'll likely see your family doctor or a general practitioner. Here's some information to help you get ready for your appointment. When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.
Abstain from sex until you see your doctor. Alert your sex partners that you're having signs and symptoms so that they can arrange to see their doctors for testing. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.
This content does not have an English version. This content does not have an Arabic version. Diagnosis To determine whether you have gonorrhea, your doctor will analyze a sample of cells. Samples can be collected by: Urine test.
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