Gonorrhea is amongst the most common sexually transmitted diseases in the world, caused by Neisseria gonorrhœae. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Clap may refer to: The act of clapping A slang term for gonorrhoea, possibly named after Margaret Clap A slang term for chlamydia CLAP (in capitals) refers to a Child Labour Action Programme This is a disambiguation page — a navigational aid which lists pages that might otherwise share the same... A sexually transmitted disease (STD), a. ...

Non-genital sites in which it thrives are in the rectum, the throat (oropharynx), and the eyes (conjunctivae). The vulva and vagina in women are usually spared because they are lined by stratified epithelial cells—in women the cervix is the usual first site of infection. Gonorrhea spreads during sexual intercourse. Infected women also can pass gonorrhea to their newborn infants during delivery, causing eye infections (conjunctivitis) in their babies (which if left untreated, can cause blindness). Doctors have often attempted to treat this immediately by applying small amounts of silver nitrate or other antibiotic to the eyes of all newborn babies. The rectum (from the Latin rectum intestinum, meaning straight intestine) is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. ... For other uses, see Throat (disambiguation). ... The pharynx is the part of the digestive system of many animals immediately behind the mouth and in front of the esophagus. ... For other uses, see Eye (disambiguation). ... Image of a human eye clearly showing the blood vessels of the conjuntiva. ... The external genital organs of the female are collectively known as the vulva (plural vulvae or vulvas)[1]. In common speech, the term vagina is often used improperly to refer to the vulva or female genitals generally, even though, strictly speaking, the vagina is a specific internal structure, whereas the... The vagina, (from Latin, literally sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. ... Stratification is the building up of layers of deposits, and can have several variations of meaning: Social stratification, is the dividing of a society into levels based on wealth or power. ... In zootomy, epithelium is a tissue composed of a layer of cells. ... The cervix (from Latin neck) is the lower, narrow portion of the uterus where it joins with the top end of the vagina. ... It has been suggested that Duration of sexual intercourse be merged into this article or section. ... A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ... R-phrases , S-phrases , , , , Flash point non-flammable Supplementary data page Structure and properties n, εr, etc. ...

Symptoms of gonorrhea

The incubation time varies from 2 to 14 days with most symptoms occurring between the second and fifth days after being infected from an infected partner. A small number of people may be asymptomatic for up to a year. Between 30–60% of women with gonorrhea are asymptomatic or have subclinical disease.^[1] The woman may complain of vaginal discharge, difficulty urinating (dysuria), off-cycle menstrual bleeding, or bleeding after sexual intercourse. The cervix may appear anywhere from normal to the extreme of marked cervical inflammation with pus. Possibility of increased production of male hormones is common in many cases. Infection of the urethra (urethritis) causes little dysuria or pus. The combination of urethritis and cervicitis on examination strongly supports a gonorrhea diagnosis, as both sites are infected in most gonorrhea patients. Gonorrhea is caused by the Neisseria gonorrhoeae bacteria. The infection is transmitted from one person to another through vaginal, oral, or anal sexual relations. In medicine, a disease is asymptomatic when it is at a stage where the patient does not experience symptoms. ... In medicine, a disease is asymptomatic when it is at a stage where the patient does not experience symptoms. ... Wikipedia does not have an article with this exact name. ... In medicine, specifically urology, dysuria refers to any difficulty in urination. ... Menstrual cycle In the female reproductive system, the menstrual cycle is a recurring cycle of physiologic changes that occurs in reproductive age females of several mammals, including human beings and other apes. ... Urethritis is inflammation of the urethra. ...

Men have a 20% chance of getting the infection by having sexual relations with a woman infected with gonorrhea. Women have a 50% chance of getting the infection by having sexual relations with a man infected with gonorrhea. An infected mother may transmit gonorrhea to her newborn during vaginal childbirth.

Less advanced symptoms, which may indicate development of pelvic inflammatory disease (PID), include cramps and pain, bleeding between menstrual periods, vomiting, or fever. It is not unusual for men to have asymptomatic gonorrhea. Men may complain of pain on urinating and thick, copious, urethral pus discharge (also known as gleet) is the most common presentation. Examination may show a reddened external urethral meatus. Ascending infection may involve the epididymis, testicles or prostate gland causing symptoms such as scrotal pain or swelling. A symptom is a manifestation of a disease, indicating the nature of the disease, which is noticed by the patient. ... Pelvic inflammatory disease (or disorder) (PID) is a generic term for infection of the female uterus, fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. ... Dysmenorrhea (or dysmenorrhoea), cramps or painful menstruation, involves menstrual periods that are accompanied by either sharp, intermittent pain or dull, aching pain, usually in the pelvis or lower abdomen. ... Not to be confused with Mensuration. ... Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... An analogue medical thermometer showing the temperature of 38. ... In medicine, specifically urology, dysuria refers to any difficulty in urination. ... In anatomy, the urethra is a tube which connects the urinary bladder to the outside of the body. ... The urinary meatus is the external orifice of the urethra, from which urine is ejected during urination. ... Male Anatomy The epididymis is part of the human male reproductive system and is present in all male mammals. ... Human male anatomy The testicles, known medically as testes (singular testis), are the male generative glands in animals. ... Male Anatomy The prostate is a gland that is part of male mammalian sex organs. ...

Complications

In men, inflammation of the epididymis (epididymitis), prostate gland (prostatitis) and urethral structure (urethritis) can result from untreated gonorrhea. Epididymitis is a medical condition in which the epididymis becomes inflamed. ... Prostatitis is any form of inflammation of the prostate gland. ...

In women, the most common result of untreated gonorrhea is pelvic inflammatory disease, a serious infection of and tenosynovitis in fingers, wrists, toes or ankles. This should be evaluated promptly with a culture of the synovial fluid, blood, cervix, urethra, rectum, skin lesion fluid, or pharynx. The underlying gonorrhea should be treated; if this is done then usually a good prognosis will follow. Tenosynovitis is the inflammation of the fluid-filled sheath (called the synovium) that surrounds a tendon. ... Synovial fluid is a thin, stringy fluid found in the cavities of synovial joints. ...

Treatment

Gonorrhea treatment advertisement from 1944, when penicillin became widely available due to mass production.

The mainstay of treatment is the appropriate use of antibiotics. While penicillin was the most common antibiotic used to treat gonorrhea up until the 1970s, an increase in antibiotic resistance has led to a decline in its use. Recommendations for first choice treatment of gonorrhea must depend on local information on resistance patterns and it is not possible to make treatment recommendations that are applicable to all parts of the world. Image File history File links PenicillinPSAedit. ... Image File history File links PenicillinPSAedit. ... Penicillin core structure Penicillin (abbreviated PCN) is a group of β-lactam antibiotics used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms. ... Staphylococcus aureus - Antibiotics test plate. ...

The Centers for Disease Control and Prevention (CDC) released a report on Thursday, April 12, 2007 officially adding gonorrhea to a list of super bugs that are now resistant to common antibiotics according to CDC. The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ... is the 102nd day of the year (103rd in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... Antibiotic resistance is the ability of a microorganism to withstand the effects of an antibiotic. ...

Antibiotics that may be used to treat gonorrhea include:

• Amoxicillin 2 g plus probenecid 1 g orally
• Ampicillin 2 to 3 g plus probenecid 1 g orally
• Azithromycin 2 g orally
• Cefixime 400 mg orally
• Cefotaxime 500 mg by intramuscular injection
• Cefoxitin 2 g by intramuscular injection, plus probenecid 1 g orally
• Cefpodoxime (Vantin) 400 mg orally
• Ceftriaxone (Rocephin) 125 to 250 mg by intramuscular injection
• Ciprofloxacin 500 mg orally
• Levofloxacin 250 mg orally
• Ofloxacin 400 mg orally
• Spectinomycin 2 g by intramuscular injection

These drugs are all given as a single dose. Amoxicillin (INN) or amoxycillin (former BAN) is a moderate-spectrum β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. ... Probenecid is a uricosuric drug, primarily used in treating gout or hyperuricemia, that increases uric acid removal in the urine. ... Ampicillin is a beta-lactam antibiotic that has been used extensively to treat bacterial infections since 1961. ... Probenecid is a uricosuric drug, primarily used in treating gout or hyperuricemia, that increases uric acid removal in the urine. ... Azithromycin is an azalide, a subclass of macrolide antibiotics. ... Cefixime is an oral third generation cephalosporin antibiotic. ... Cefotaxime (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Second−generation cephalosporin: active against a wide spectrum of gram−negative bacteria including anaerobes (B fragilis). ... Probenecid is a uricosuric drug, primarily used in treating gout or hyperuricemia, that increases uric acid removal in the urine. ... Cefpodoxime is an oral third generation cephalosporin antibiotic. ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Ciprofloxacin is the generic international name for the synthetic antibiotic manufactured and sold by Bayer Pharmaceutical under the brand names Cipro, Ciproxin and Ciprobay (and other brand names in other markets, e. ... Levofloxacin is an advanced generation fluoroquinolone antibiotic, marketed by Ortho-McNeil under the trade name Levaquin in the United States. ... Ofloxacin sold under the brand name Floxin in the US. It is a quinolone antibiotic. ... Spectinomycin hydrochloride (Trobicin®) is an aminocyclitol antibiotic produced by the bacteria Streptomyces spectabilis. ...

The level of tetracycline resistance in Neisseria gonorrhœae is now so high as to make it completely ineffective in most parts of the world. Tetracycline (INN) (IPA: ) is a broad-spectrum antibiotic produced by the streptomyces bacterium, indicated for use against many bacterial infections. ...

The fluoroquinolones (penisciprofloxacin, ofloxacin, levofloxacin) cannot be used in pregnancy. It is important to refer all sexual partners to be checked for gonorrhea to prevent spread of the disease and to prevent the patient from becoming re-infected with gonorrhea. Patients should also be offered screening for other sexually transmitted infections. In areas where co-infection with chlamydia is common, doctors may prescribe a combination of antibiotics, such as ceftriaxone with doxycycline or azithromycin, to treat both diseases. Chlamydia is a common term for Chlamydiae. ... Doxycycline (INN) (IPA: ) is a member of the tetracycline antibiotics group and is commonly used to treat a variety of infections. ...

Penicillin is ineffective at treating rectal gonorrhea: this is because other bacteria within the rectum produce β-lactamases that destroy penicillin. All current treatments are less effective at treating gonorrhea of the throat, so the patient must be rechecked by throat swab 72 hours or more after being given treatment, and then retreated if the throat swab is still positive.

Although gonorrhea usually does not require follow-up (with the exception of rectal or pharyngeal disease), patients are usually advised to phone for results five to seven days after diagnosis to confirm that the antibiotic they received was likely to be effective. Patients are advised to abstain from sex during this time.

Drug resistant strains are known to exist.

United States recommendations

The United States does not have a federal system of sexual health clinics, and the majority of infections are treated in family practices. A third-generation cephalosporin antibiotic such as ceftriaxone is recommended for use in most areas. Since some areas such as Hawaii and California have very high levels of resistance to fluoroquinolone antibiotics (ciprofloxacin, ofloxacin, levofloxacin) they are no longer used empirically to treat infections originating in these areas. The cephalosporins, are a class of β-lactam antibiotics. ... Ceftriaxone (INN) (IPA: ) is a third-generation cephalosporin antibiotic. ... Quinolones and fluoroquinolones form a group of broad-spectrum antibiotics. ... Ciprofloxacin is the generic international name for the synthetic antibiotic manufactured and sold by Bayer Pharmaceutical under the brand names Cipro, Ciproxin and Ciprobay (and other brand names in other markets, e. ... Ofloxacin sold under the brand name Floxin in the US. It is a quinolone antibiotic. ... Levofloxacin is an advanced generation fluoroquinolone antibiotic, marketed by Ortho-McNeil under the trade name Levaquin in the United States. ...

Since 1993, fluoroquinolones (i.e., ciprofloxacin, ofloxacin, or levofloxacin) have been used frequently in the treatment of gonorrhea because of their high efficacy, ready availability, and convenience as a single-dose, oral therapy. Beginning in 2000, fluoroquinolones were no longer recommended for gonorrhea treatment in persons who acquired their infections in Asia or the Pacific Islands (including Hawaii); in 2002, this recommendation was extended to California (2). In 2004, CDC recommended that fluoroquinolones not be used in the United States to treat gonorrhea in men who have sex with men (MSM). On the basis of the most recent evidence, CDC no longer recommends the use of fluoroquinolones for the treatment of gonococcal infections and associated conditions such as pelvic inflammatory disease (PID). Consequently, only one class of drugs, the cephalosporins, is still recommended and available for the treatment of gonorrhea.

The Center for Disease Control has recently (April 2007) updated treatment guidelines. http://www.cdc.gov/std/treatment/2006/updated-regimens.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5614a3.htm?s_cid=mm5614a3_e

Antibiotics can successfully cure gonorrhea in adolescents and adults. However, drug-resistant strains of gonorrhea are increasing in many areas of the world, including the United States, and successful treatment of gonorrhea is becoming more difficult. Because many people with gonorrhea also have chlamydia, another sexually transmitted disease, antibiotics for both infections are usually given together. Persons with gonorrhea should be tested for other STDs. It is important to take all of the medication prescribed to cure gonorrhea. Although medication will stop the infection, it will not repair any permanent damage done by the disease. People who have had gonorrhea and have been treated can get the disease again if they have sexual contact with persons infected with gonorrhea. If a person's symptoms continue even after receiving treatment, he or she should return to a doctor to be reevaluated.

United Kingdom recommendations

In the United Kingdom, the majority of patients with gonorrhea are treated in dedicated sexual health clinics. The current recommendation is for ceftriaxone or cefixime as first line therapy; no resistance to either drug has yet been reported in the UK. Levels of spectinomycin resistance in the UK are less than 1%, which would make it a good choice in theory, but intramuscular spectinomycin injection is very painful.

Azithromycin (given as a single dose of 2 g) is recommended if there is concurrent infection with chlamydia. A single dose of oral ciprofloxacin 500 mg is effective if the organism is known to be sensitive, but fluoroquinolones were removed from the UK recommendations for empirical therapy in 2003 because of increasing resistance rates. In 2005, resistance rates for ciprofloxacin were 22% for the whole of the UK (42% for London, 10% for the rest of the UK).^[2]

Historically

Historically it has been suggested that mercury was used as a treatment for gonorrhea. Surgeons tools on board the recovered English warship the Mary Rose included a syringe that, according to some, was used to inject the mercury via the urinary meatus into any unfortunate crewman suffering from gonorrhea. Silver nitrate was one of the widely used drugs in the 19th century, but it became replaced by Protargol. Arthur Eichengrün invented this type of colloidal silver which was marketed by Bayer from 1897 on. The silver-based treatment was used until the first antibiotics came in use in the 1940's.^[3] This article is about the element. ... Mary Rose depicted on the Anthony Roll, a survey of Henry VIIIs navy, completed in 1546 The Mary Rose was an English Tudor warship of the carrack type and one of the first to be able to fire a full broadside of cannons. ... A syringe nowadays nearly always means a medical syringe, but it can mean any of these: A simple hand-powered piston pump consisting of a plunger that can be pulled and pushed along inside a cylindrical tube (the barrel), which has a small hole on one end, so it can... The urinary meatus is the external orifice of the urethra, from which urine is ejected during urination. ... R-phrases , S-phrases , , , , Flash point non-flammable Supplementary data page Structure and properties n, εr, etc. ... Colloidal silver is a colloid of silver particles in water. ... Arthur Eichengrün (August 13, 1867 - December 23, 1949) was a German chemist. ... Bayer AG (IPA pronunciation //) (ISIN: DE0005752000, NYSE: BAY, TYO: 4863 ) is a German chemical and pharmaceutical company founded in Barmen, Germany in 1863. ...

Prevalence

Gonorrhea is a very common infectious disease. The CDC estimates that more than 700,000 persons in the United States get new gonorrheal infections each year. Only about half of these infections are reported to CDC. In 2004, 330,132 cases of gonorrhea were reported to the CDC. After the implementation of a national gonorrhea control program in the mid-1970s, the national gonorrhea rate declined from 1975 to 1997. After a small increase in 1998, the gonorrhea rate has decreased slightly since 1999. In 2004, the rate of reported gonorrheal infections was 113.5 per 100,000 persons.

Slang terms

Gonorrhea is also commonly known by the slang term the clap.

Suggested etymology:

• Reference to a traditional treatment used to clear the blockage in the urethra from gonorrheal pus, where the penis would be "clapped" on both sides simultaneously.^[4]
• Reference to the painful sting in the male urethra, which feels like the sting of a clap (as in clapping hands) when infected with the disease.
• From the old French word "clapier", meaning "brothel".

A brothel, also known as a bordello or whorehouse, is an establishment specifically dedicated to prostitution, providing the prostitutes a place to meet and to have sex with the clients. ...

References

Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 301st day of the year (302nd in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

External links

Wikimedia Commons has media related to:

Gonorrhea

• Centers for Disease Control and Prevention: Gonorrhea Information
• Drug-resistant gonorrhea on rise among gay men
• National Institute of Allergy and Infectious Diseases: Gonorrhea Factsheet
• MayoClinic.Com: Gonorrhea
• It's Your Health - Gonorrhea at Health Canada Retrieved 2 May 2007.
• Gonorrhea Info Treatments and Symptoms other aditional info