Urethritis and gonorrhoea Flashcards
(33 cards)
What’ urethritis? (simply)
Inflammation of the urethra
Types of urethritis (2)
- gonoccocal - caused by sexually transmitted gonorrhoea
- non- gonococcal - not caused by gonorrhoea
symptoms of urethritis
- pain
- urinary frequency
- a burning sensation upon urination (dysuria)
- cloudy/white discharge (from penis, vagina)
- itching
What organism causes Gonorrhoea?
Neisseria Gonorrhoea
*gram - negative bacteria
What’s non-gonococcal urethritis?
urethritis when gonococcal bacteria are not identified on the initial swab
*symptomatic patient (dysuria, discharge)
* swab taken-> microscopy performed which showed neutrophils but no Gram negative diplococci (i.e. no evidence of gonorrhoea).
*immediate treatment required prior to waiting for the Chlamydia test to come back
*hence an initial diagnosis of NGU is made.
What are two most common bacterial STIs?
gonorrhoea is the second most common bacterial STI (after chlamydia)
How gonorrhoea is transmitted?
- through anal/vaginal/oral sex
- from mother to child
What can be infected by Neisseria Gonorrhoea?
Neisseria Gonorrhoea has a strong affinity for mucous membranes
- uterus
- urethra
- cervix
- fallopian tubes
- ovaries
- testicles
- rectum
- throat
- less commonly the eyes
Risk factors for gonorrhoea
- Aged <25 years
- Men who have sex with men
- Living in high-density urban areas
- Previous gonorrhoea infection
- Multiple sexual partners
Is gonorrhoea symptomatic or asymptomatic?
- often asymptomatic
When do the symptoms of gonorrhoea infection develop?
2-5 days following infection
(but often asymptomatic)
What’s that?
Vaginal discharge in a female with gonorrhoea
Symptoms of a female gonorrhoeal infection
- altered/increased vaginal discharge (often green/yellow)
- dysuria
- lower abdo pain
- rarely post-coital, inter-menstrual bleeding
Signs of female gonorrhoeal infection
- easily induced cervical bleeding
- endocervical discharge (mucopurulent)
- pelvic tenderness
(but often examination can be normal!)
Male symptoms of gonorrhoea
- uretheral discharge (purulent/mucopurulent)
- dysuria
Signs of gonorrhoeal infection in men (2)
- Mucopurulent/purulent urethral discharge
- Epididymal tenderness
Symptoms of gonorrhoeal rectal infection
- Usually asymptomatic
- Anal discharge
- Anal pain/discomfort
Symptoms of gonorrhoeal pharyngeal infections
usually asymptomatic (>90% cases)
Investigations for gonorrhoea
- if suspected → refer to GUM or specialist sexual service
Microscopy
Culture
Nucleic Acid Amplification Test (NAAT)/PCR
What’s NAAT test?
NAAT - ucleic acid test or nucleic acid amplification test
- technique utilized to detect a particular nucleic acid, virus, or bacteria which acts as a pathogen in blood, tissue, urine, etc.
- NAT system differs from other tests in that it detects genetic materials rather than antigens or antibodies
Ix for female gonorrhoea (2)
Females:
- Endocervical/vaginal swab – NAAT
- Endocervical/urethral swab – microscopy and culture
Tests for male gonorrhoea (2)
- First pass urine – NAAT
- Urethral/meatal swab – microscopy and culture
Where else, apart from genitals, can we obtain swabs if gonorrhoea is suspected?
Swabs for NAAT + microscopy & culture can be obtained from the throat, rectum or eye if indicated
What else NAATs are used for?
NAATs are the standard investigation for chlamydia and these tests often provide dual testing for both chlamydia and gonorrhea.
