Gonorrhea.SIGNS AND SYMPTOMS.
Ten percent of males and 20% to 40% of females are asymptomatic.
Uncomplicated anogenital female: Endocervix, urethra, Skene’s gland, Bartholin’s gland, and anus sites may be infected.
- Urethral or vaginal discharge.
Dysuria, abnormal bleeding.
Mucopurulent endocervical exudates.
Nongenital symptoms may result from direct or contiguous spread and bloodstream dissemination.
Pelvic inflammatory disease (PID) occurs in 15% to 20% of women with uncomplicated anogenital gonorrhea.
Anorectal infection: 30% to 40% of patients with positive endocervical gonorrhea culture (GC) will have positive anorectal cultures.
Perihepatitis (Fitz-Hugh—Curtis syndrome) may occur.
Conjunctivitis may occur as well.
Pharyngitis occurs in 10% to 20% of women with genital tract gonorrhea; it is most often asymptomatic.
Disseminated gonorrhea occurs when an infection of the genital tract, pharynx, or rectum invades the bloodstream.
Prevalence: 0.1% to 0.3% of total gonorrhea
The disease’s two stages are as follows: (a) Bacteremia
Fever 38° to 39° C
Skin lesions: erythematous macules 1 to 5 mm in diameter located on extremities secondary to gonococcal emboli
Positive blood cultures in 50%
Endocarditis or meningitis may ensue (b) Septic arthritis
Purulent synovial effusion
Knees, ankles, and wrists: erythema, edema, and pain
Negative blood cultures