Gonorrhoea
Last Updated: 2020-11-19
ICD11: 1A7Z
Last Updated: 2020-11-19
Author(s): Anzengruber F., Navarini A.
ICD11: 1A7Z
Neisser 1879.
Gonorrhea, Neisser's disease.
A sexually transmitted infectious disease (STI or STD) caused by Neisseria gonorrhoeae that occurs worldwide. It is seen as an indicator for the prevention of HIV and other STDs, as it is often a co-infection (ulcers serve as entry portal).
Men:
Women:
Extra-genital manifestation
Pharyngeal or anal complaints: For pharyngitis and anal complaints see Table 3.
Table 1. diagnostic steps in all urethritis patients step |
Sample collection |
Processing |
For the detection of |
---|---|---|---|
1) |
Men: Swab from the urethra with the eSwab with thin swab (Figure 1):
Women: If culture is desired, take a smear of endocervix in gynaecology. |
Step 1a:
|
Gram-negative diplococci (Neisseria gonorrhoeae),
|
Step 1b):
|
|
||
Step 2) |
Men: first urine (at least 2 hours after last micturition)
|
Maintenance |
Neisseria gonorrhoeae - PCR, Chlamydia trachomatis - PCR |
Step 3) |
Blood sample collection |
Maintenance |
Lues serology, HIV Test |
Table 2: Diagnostic steps in case of persistent symptoms after therapy (after consultation with a management physician) |
Sample collection |
Processing |
Detection of |
---|---|---|---|
Step 1) |
Urethral smear |
Put the smear into the medium |
Mycoplasma genitalium - PCR, Trichomonas vaginalis - PCR |
Genito-anal, pharyngeal, less frequently other localizations.
Men
Women
Barrier measures (attention oral sex).
In general, the therapy recommendation is based on the pathogen detection.
The therapy during the first visit to the clinic depends on the results of the direct preparation (Table 1.)
Table 1. therapy recommendation according to the result of the direct preparation test result |
Interpretation | Procedure / Therapy |
Direct preparation not conspicuous | Unclear urethritis |
No therapy Protected sex only, Control in 1 week |
In the direct preparation gram-negative diplococci (especially intracellular) and leukocytes (> 5/visual field) |
Gonorrhea |
Ceftriaxone i.m. 1.0g single dose |
In the direct preparation leucocytes (> 5/visual field) and possibly bacteria |
Non-gonorrheic urethritis |
Doxycycline p.o. 100 mg 2x/d for 7 days
|
Further recommendations
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