Sexual Health

Gonorrhoea

Neisseria gonorrhoeae is a sexually transmitted infection whose treatment is governed by antimicrobial resistance. The safe pathway is site-complete NAAT plus culture and susceptibility testing, ceftriaxone-led treatment, resistance-aware test of cure and urgent escalation for disseminated or ocular disease.

Definition

Gonorrhoea is a sexually transmitted infection caused by the Gram-negative diplococcus Neisseria gonorrhoeae. It can infect the urethra, endocervix, rectum, pharynx, conjunctiva and mucosal tissue after gender-affirming surgery.

First principles

A pyogenic organism creates a characteristic inflammatory presentation

N. gonorrhoeae infects mucosal sites including the urethra, endocervix, rectum and pharynx. A brisk neutrophil-rich response can produce profuse purulent urethral discharge and dysuria, but cervical, rectal and pharyngeal infection may be mild or asymptomatic. Symptoms therefore depend on site and host anatomy rather than reliably excluding transmission.

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