Gonorrhoea (clap)

Explanation

Gonorrhoea is a sexually transmitted disease caused by the bacterium "Neisseria gonorrhoeae" (Gonococcus). The name is derived from the symptoms and literally means "sperm flow".
The number of new infections in Germany is about 10 / 100,000 inhabitants per year.

Transmission and symptoms

Transmission occurs from person to person during sexual intercourse as a so-called smear infection. The main symptom is inflammation of the urethra (urethritis), which manifests itself through burning and purulent discharge. Depending on the contact, other organs may also be infected, including the rectum or throat, but also the eyes (conjunctiva) when a newborn baby comes into contact with the birth canal.
Die The incubation period, i.e. the time between contact and symptoms, is about 3 - 10 days.
Ascending infections should be mentioned as complications. The prostate and epididymis in men and the uterus or ovaries in women can be affected. Without treatment, this can result in permanent infertility. Furthermore, narrowing of the urethra through scarring (strictures) (link to urethral surgery) is a further possible consequence.

Diagnosis

The diagnosis is made by taking swabs, which are cultivated on special nutrient media. Direct detection from the smear material under the microscope is also possible after prior staining. In addition, diagnosis can be made through appropriate DNA detection (using the so-called PCR method). In Germany, the disease ceased to be notifiable in 2001.

Therapy

For uncomplicated cases, a combination therapy of the antibiotics ceftriaxone (1 g i.m. or i.v.) plus azithromycin (1.5 g p.o.) as a single dose is currently (as of 2018) recommended. In severe cases a longer therapy may be necessary.
Since the gonorrhoea pathogen often develops resistance to antibiotics, these recommendations may change rapidly in the future. Ciprofloxacin, which has been in use for a long time, now shows a resistance rate of > 50%!