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- Metee Comkornruecha, MD*
- *Division of Adolescent Medicine, Miami Children's Hospital, Miami, FL.
Author Disclosure
Dr Comkornruecha has disclosed no financial relationships relevant to this article. This commentary does not contain discussion of unapproved/investigative use of a commercial product/device.
- DGI:
- disseminated gonococcal infection
- EPT:
- expedited partner therapy
- MSM:
- men who have sex with men
- NAAT:
- nucleic acid amplification test
- PID:
- pelvic inflammatory disease
- STD/I:
- sexually transmitted disease/infection
- USPSTF:
- United States Preventative Services Task Force
Educational Gaps
Adolescents (15–19 years of age) and young adults (20–24 years of age) account for the majority of new cases of gonorrhea reported each year. Gonococcal infections in postpubertal females are commonly asymptomatic. Complications such as pelvic inflammatory disease (PID) and disseminated gonococcal infection (DGI) occur more often in females, probably because of delays in diagnosis and treatment.
A major difficulty in the treatment of gonococcal infections is the increasing incidence of multidrug-resistant strains. In August 2012, the Centers for Disease Control and Prevention (CDC) updated gonorrhea treatment guidelines and no longer recommends oral cephalosporins as routine treatment. (1)
Objectives
After finishing this article, readers should be able to:
Discuss the risk factors for acquisition of Neisseria gonorrhoeae.
Recognize the different clinical manifestations of gonococcal infections.
Understand the importance of following current treatment recommendations for N gonorrhoeae.
Epidemiology
Neisseria gonorrhoeae is an oxidase-positive diplococcus that grows in warm, moist environments. The optimal temperature for growth is 35° to 37°C. (2) Typically an intracellular organism, N gonorrhoeae cannot live outside of its human host and is differentiated from other species of Neisseria by its ability to ferment glucose instead of other carbohydrates. The organism survives and replicates within host macrophages after phagocytosis but is killed by polymorphonuclear leukocytes. N gonorrhoeae is shed in exudates and secretions transmitted through intimate contact, such as sexual contact or vaginal delivery.
N gonorrhoeae is the second most commonly occurring reportable sexually transmitted disease (STD), or sexually transmitted infection (STI; currently the more accepted term), after Chlamydia trachomatis. Incidence of gonococcal infections is estimated at 700,000 new cases in the United States per year. (1) Although incidence rates had declined to …
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