GONORRHEA

039
020
050

Anci Onasis Beda

110 097

Fatimah D.B.Mala

110 206

Marilyn

110 206

ADVISOR :
dr. Nasriyani Zainal
SUPERVISOR :
dr. Sri Vitayani Muchtar, Sp. KK

INTRODUCTION

Gonorrhea : Bacterial Infection

caused by Neisseria gonorrhoeae

The infection is almost always

contracted during sexual activity

EPIDEMIOLOGY
SEX
: = 1,5 : 1

GONORRHEA
RACE
Whole world

AGE
15 19 y.o
(80% cases)

ETIOLOGY

Neisseria gonorrhoeae

PATHOGENESIS

To be based on morphology, N. gonorrhoeae

devided 4 type, but only type 1st & 2nd
were phatogenic for human

Pili play an important role

The adherence of gonococci to the human

epithelial host cell an to polymorphonuclear
neutrophiles is dependent on the pili and
opa ligands

CLINICAL FEATURES

Incubation period varies from 2-5

days
In men
Symptomatic
In women
Asymptomatic

CLINICAL FEATURES
Gonococcal Infection in men
(incubation period
2-5 days) :
Urethral discomfort
Dysuria
Purulent discharge
Polyuria and urgency
Red or swollen opening of penis
(urethra)
Tender or swollen testicles

CLINICAL FEATURES

Adult women (asymphtomatic)

Increased vaginal discharge
Dysuria
Intermenstrual bleeding
Menorrhagia
Dispareunia

CLINICAL FEATURES

Ophtalmia Neonatorum
Purulent conjuntivitis
Eye pain, redness and purulent
discharge

DIFFERENTIAL
DIAGNOSIS

Male
Urethritis Non Gonorrhea (UNG)

DIFFERENTIAL
DIAGNOSIS

Female

Trichomonas vaginalis infection (Trichomoniasis)

Candida albicans infection (Candidosis vaginalis)

DIFFERENTIAL
DIAGNOSIS
-

Gardnerella vaginalis infection (Bacterial

vaginosis)

DIAGNOSIS

History taking
Physical examination
Supporting examination

COMPLICATION

Male
Epididymitis gonococcal
Inflamation and abscess formation in
parafrenal & bulbourethral glands
Periurethral abscess
Prostatitis
Seminal vesiculitis
Urethral stricture

COMPLICATION

Female
Acute salpingitis
Pelvic Inflammatory Disease (PID)
Bartholinitis and Bartholins abscess

COMPLICATION

Disseminated Gonococcal Infection

Arthritis-dermatosis syndrome
Gonococcal endocarditis &
meningitis

TREATMENT

Depends on :
Antimicrobial resistance of the microorganism
The anatomical site of gonococcal
infection
Clinical symptoms
Side effect of the drug
Cost
Possibly coexisting chlamydial infection

TREATMENT

Uncomplicated gonococcal infection of

the cervix, urethra and rectum :

Recommended
Alternative regimens
regimens
Ceftriaxone 125-250 mg
IM as single dose
Spectinomysin 2 gr
IM as single dose
Cefixime 400 mg oral as
single dose
Ciprofloxacin 500 mg
oral as single dose
Ofloxacin 400 mg oral
as single dose

Penicillin regimens 23 gr peroral plus

Probenedic
1 gr as single dose

TREATMENT

Gonorrhea with coexisting Chlamydial

infection :

Azitromycin 1 gr as single dose, or

Doxycycline 100 mg for 7 days

TREATMENT

Pregnancy/Breastfeeding :

Ceftriaxone 250 mg IM, as single dose, or

Spectinomycin 2 gr IM, as single dose, or
Amoxisilin 2 - 3 gr peroral plus
probenecid 1 g peroral, as single dose
(N.gonorrhoeae sensitive to penicillin)

TREATMENT

Disseminated gonococcal infection

Ceftriaxone 1 gr IM or IV every 24 hours, or

Cefotaxime 1 gr IV every 8 hours, or
Ciprofloxacin 500 mg IV every 12 hours

TREATMENT

Opthalmia neonatorum

Ceftriaxone 25-50 mg/kg IV or IM, as

single dose

PROGNOSIS

Most gonococcal infection respond

quickly to antibiotic therapy
Prognosis is excellent if therapy is
initiated promptly and completed

THANK YOU