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July 05, 2007
Gonorrhea - over 650,000 reported cases annually
By: Dr. S. Lawson
onorrhea ( Neisseria Gonorrhea) is the second most common bacterial infectious disease in the United States. Gonorrhea and Chlamydia usually walk hand in hand. Approximately 650,000 reported cases occur annually. However, it is estimated that if under-diagnosed and unreported cases were accounted for, the actual infection rate would be twice this number.
The highest occurrences of Gonorrhea infections are among females between ages 15 to 19 and highest rates among males are between ages 20 to 24. It is more common among younger females because the vaginal epithelium is thinner.
This infection can be contracted through, vaginal, anal, and oral sex. Gonorrhea can infect the cervix, uterus, fallopian tubes of women and the urethra, mouth, throat, and rectum of both sexes. Pelvic inflammatory disease (PID) is a common complication of gonorrhea in women and epididymitis (infection of the spermatic duct) in men can lead to sterility. Arthritic joint pain, meningitis (infection of the tissue that covers the brain) and heart disease (endocarditis) are rare complications of gonorrhea infection.
Gonorrhea infections do not present with any symptoms 90 % of the time in females. However when they do occur, the symptoms present as burning urination, yellow-green discharge from the vagina, abdominal and pelvic pain, feelings of incomplete emptying of the bladder, fever, unusual vaginal bleeding, bleeding after sexual activity, painful sexual activity, swelling and tenderness of the vulva (female external genitalia). In males symptoms present as burning urination, yellow-white penile discharge, fever, and swollen or painful testicles. With both sexes symptoms may present as sore throat (pharynxgitis), rectal soreness, rectal pus-like bloody discharge, anal itching and painful bowel movements. Symptoms may take from 2 to 30 days to present after initial infection.
This infection can be confused with urinary tract infection (UTI) and, in some cases, is only recognized when a partner is diagnosed. A DNA technique is used to detect this infection. This organism can live up to 4 hours outside the body; consequently, it is possible to contract this infection from the hands of infected individuals. The penis and tongue does not have to enter the anus, vagina, or mouth for infection to occur. Latex condom from the initiation of sexual activity will reduce transmission rate. Sharing clothing (i.e. bathing suit), washcloth of infected individual can result in transmission of the organism. New born can become infected from infected mothers.
Treatment of gonorrhea is becoming a major heath concern because of resistance to different classes of antibiotics (penicillin, sulfa drugs, tetracycline), and most recently the floroquinolones (ciprofloxacin, levoquin, and oflaxacin). The presence of mercury (and other heavy metals) in the enviornment and in the body contributes to development of resistance to these classes of antibiotics.
Gonorrhea, either alone or in combination with other organisms, is found in 40 % to 60% of cases of pelvic inflammation. Infected women who are not treated early enough usually develop Pelvic inflammatory disease (PID). Systemic symptoms are fever, nausea and vomiting. The infection produces inflammation that results in adhesion and abscess (walled-off pockets of infection) formation. If the infection enters the abdominal cavity, it can result in infection around the liver (perihepatitis).
Most cases of PID are caused by multiple infections, when gonorrhea is detected all antibiotics regimen must cover both Gonorrhea and Chlamydia because most cases of gonorrhea infection are accompanied by Chlamydial infection.
Men and women infected with gonorrhea are more susceptible to HIV infection. STDs also increase the chances of developing cervical cancer. Women infected with the Human Papilloma virus (HPV) before the age of 25 are 40 times more likely to develop cervical cancer. Other viruses like Herpes simplex virus, Epstein-barr virus (also called the kissing disease) can contribute to the development of cervical cancer.
These viruses may act as tumor promoters. High risk behaviors ( multiple sexual partners, an increase rate of acquiring new partners, unprotected sex, illicit drugs use and alcohol intoxication) contribute to the acquisition of viral and bacterial infections by disturbing the delicate ecology of the healthy vagina. Although the PAP smear has significantly decreased the mortality and morbidity of cervical cancer, one of the best screen test for malignancy, the incidence of cervical cancer has increased in young women. Early sexual activity is a risk factor for cervical cancer. Gonorrhea infection has been linked with the development of bladder cancer in men.