Sexually+Transmitted+Diseases-+Gonorrhea

Gonorrhea ** Sarah Spillane ** May 20, 2010  **Abstract** Sexually Transmitted Diseases, otherwise known as STDs or STIs, are diseases that are contracted by having sex with someone who was infected with an STD. You can get an STD from having sexual activity that involves the mouth, anus, vagina, and penis. The second most common STD is gonorrhea. Gonorrhea is caused by ** the gram-negative diplococcus //Neisseria gonorrhoeae//. Gonorrhea can be spread through sexual contact between two people when one has the STD or can be passed from an infected mother to her baby during childbirth. Many of the symptoms of gonorrhea are either invisible to the eye or misdiagnosed, if there is any doubt in your mind, it is always important to get tested. This STD can be cured by antibiotics, but if left untreated it can cause serious bodily complications. This paper also begins to describe how some drugs are becoming resistant to gonococcus bacterium. **  ** Introduction **

** Gonorrhea also known as "clap" is an ancient disease in which was described and given its present name by the Greek Physician Galen in A.D. 150. The name comes from //gon//=semen+ //rea//=flow in which Galen confused Pus with semen. Each year in the United States more than 300,000 cases are still being reported. More than 60% of people with gonorrhea are between the ages of 15 and 24. (WebMD)These gram-negative bacterium **grow rapidly and multiply in the mucous membranes, especially the mouth, throat, and anus of males and females, and the cervix, fallopian tubes, and uterus of the female reproductive tract. To infect the body the gonococcus must attach to the mucosal cells of the epithelial walls by means of the frimbia. (WebMD)The pathogen invades the spaces separating columnar epithelial cells, which are found in the oral pharyngeal area, the eyes, rectum, urethra, openings of the cervix, and the external genitals of females before puberty. Women become infected 60-90% of the time from a single exposure while men are only infected 20-30% of the time from one exposure. (Tortora, Funke, and Case 747-750) **// Neisseria gonorrhoeae //**** is a sub category of Betaproteobacteria. **


 * Discussion **

** Transmission **- The transmission of gonorrhea can be spread in two different ways. The first way in which gonorrhea can also be spread is through sexual contact between two partners regardless of gender. Gonorrhea is spread though contact with penis, vagina, mouth, or anus. Gonorrhea can also be spread through a mother to a baby during delivery. (Weinstock H., Berman S., Cates W., 2004) The baby is then infected as it passes through the birth canal during child birth. According to the Center for Disease Control and Prevention, when a baby is infected with gonorrhea some of the symptoms could be blindness, joint infection, or a life-threatening blood infection. (Center of Disease Control and Prevention (CDC), 2007) The condition of blindness in children is known as opthalmia neonatorum. (Tortora, Funke, and Case., 2010, pg 748)

**Symptoms**- //(can show from within 2-5 days and even sometimes up to 30 days)//

**Men-** Some of the direct symptoms and signs that men might become aware of include a burning sensation when urinating, a yellow, white, or green discharge from the penis and in some situations men with gonorrhea may get painful or swollen testicles. In some male hosts, a urethral infection might lead to symptomatic inflammatory response.


 * Women-** Most women who are infected with gonorrhea have no symptoms. Most women usually mistake their symptoms for bladder or vaginal infections. The initial symptoms and signs in women include a painful burning sensation when urinating, increased vaginal discharge, or vaginal bleeding between periods.Gonoccal disease is a common cause for female infertility, but if the infection gets into the endocervix or the mucous membrane the signs are less obvious. Some forms of gonococci may remain in the urethra or endocervix for long periods of time without producing symptoms. The reasons for this latent infection are not known, "but these gonococcal strains have unique nutritional requirements, extreme sesitivity to antibiotics, and limited ability to activate the bacteria." (Cohen, Sparling. 1992)


 * Both-** Men and women might have the same possible symptoms of pharyngeal gonorrhea which resembles a septic sore throat or anal gonorrhea which can be painful and accompanied with a discharge of pus. Both of these symptoms are not uncommon and are limited to scratching.


 * Complications of the Body **

If gonorrhea goes untreated in both men and women systemic infections will begin to cause complications in different parts of the body. There are three different kinds of complications of the body that could come with untreated gonorrhea. The first is //gonorrheal endocarditis// which has complications with joints and the heart. The second is //gonorrheal meningitis// which has complications with the eyes, pharynx, or other parts of the body. The last complication is gonorrheal arthritis which is caused by the growth of the gonococcus fluids in joints, most commonly wrists, knees and ankles, this occurs in only 1% of cases. (Tortora, Funke, and Case. 747-750) The main complication of untreated gonorrhea in women is Pelvic Inflammatory Disease (PID). PID could be mild or severe and can include abdominal pain and fever. “PID can lead to damage of the fallopian tubes which could cause infertility and increases the risks of ectopic pregnancy. For men, gonorrhea can cause epididymitits, which is a painful condition of the ducts attached to the testicles, which can lead to infertility if left untreated.” (CDC, 2007)

There are not many ways of diagnosing gonorrhea, because symptoms are not always obvious people should get tested right away if they see any symptoms or are have unexplained pain. The easiest way to diagnose gonorrhea is through a gram stain. A physician can obtain a sample for testing from the bodily parts that are infected, for example the cervix, urethra, rectum, or the throat. (CDC, 2007) If gonorrhea is present in the cervix or the urethra than it is also possible to test the urine to diagnose a problem. For men most doctors would gram stain a smear of pus, but for women they would take a smear from the urethra and cervix to gram stain to look for gonorrhea. (CDC, 2007). If positive for gonorrhea, the gram stain should have gram-negative diplococcus //Neisseria gonorrhoeae// present.
 * Diagnosis **


 * Treatments **

Several different treatments are available to treat gonorrhea in adults and adolescents. The occurrences of gonorrhea in the United States and abroad, especially under-developed and developing countries, has decreased in the last two decades. As of recently, though, higher rates of infection have been reported due to the increase of antimicrobial-resistant gonococci (Knapp et al., 1994). According to Jennifer Warner “ If trends continue, researchers say there is a very real possibility that some strains of //Neisseria gonorrhoeae// may become resistant to all current treatment options.” (Warner, J., 2010 ) As of right now, the current drug of choice is either ceftriaxone and cefixime. Although these two drugs are still very effective they are already showing signs of resistance, especially to cefixime. If this problem of resistance to medication is not resolved, there is a real possibility that gonorrhea will be a very difficult infection to treat. (Warner, J., 2010).


 * Prevention **

The surest way you can truly avoid transmission of STDs is to abstain from sexual intercourse or to be in a long term monogamous relationship with a partner who has been tested and known to be uninfected. In most cases Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea. (CDC, 2007) If you have had gonorrhea in the past and have been treated it is still possible to get it again while having sexual contact with another infected individual.










 * Literature Cited **

Centers for Disease Control and Prevention (CDC). //Sexually Transmitted Disease Surveillance, 2006//. Atlanta, GA: U.S. Department of Health and Human Services, November 2007.

Centers for Disease Control and Prevention (CDC), Division of STD Prevention. //Sexually Transmitted Disease Surveillance, 2007//. Atlanta, GA: U.S. Department of Health and Human Services, November 2008. http://www.cdc.gov/std/stats07/slides.htm

Cohen M.S., Sparling P.F., “//Mucosal infection with Neisseria gonorrhoeae : bacterial adaptation and mucosal defenses”//. Journal of Clinical Investigation 1992; 80:1699-1705.

Knapp, J.S., R. Ohye, S.W. Neal, M.C. Parekh, H. Higa, and R.J. Rice. 1994. Emergine in vitro resistance to quinolones in penicillinase-producing //Neisseria gonorrhoeae// strains in Hawaii. //Antimicrobial Agents and Chemotherapy//. 38:2200-2203.

Tortora, Gerard, Berdell Funke, and Christine Case. //Microbiology an Introduction//. 10th. San Francisco: Pearson Benjamin Cummings, 2010. 747-750.

Warner, Jennifer. “//Antibiotic Resistance Pushing Gonorrhea Toward Superbug Status.” WebMD // March 29, 2010 .http://www.webmd.com/sexual-conditions/news/20100329/gonorrhea-getting-harder-to-treat

WebMD- www.WebMD.com

Weinstock H, Berman S, Cates W. //Sexually transmitted disease among American youth: Incidence and prevalence estimates,// 2000. Perspectives on Sexual and Reproductive Health 2004; 36: 6-10.