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Gonorrhea

Disease Details

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Description: Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae, affecting the genital tract, rectum, and throat.
Type: Gonorrhea is a bacterial infection caused by Neisseria gonorrhoeae. It is not transmitted genetically; rather, it is commonly transmitted through sexual contact with an infected person.
Signs And Symptoms: Gonorrhea infections of mucosal membranes can cause swelling, itching, pain, and the formation of pus. The time from exposure to symptoms is usually between two and 14 days, with most symptoms appearing between four and six days after infection, if they appear at all. Both men and women with infections of the throat may experience a sore throat, though such infection does not produce symptoms in 90% of cases. Other symptoms may include swollen lymph nodes around the neck. Either sex can become infected in the eyes or rectum if these tissues are exposed to the bacterium, which can lead to pain with bowel movements, rectal discharge, or constipation.
Prognosis: Gonorrhea if left untreated may last for weeks or months with higher risks of complications. One of the complications of gonorrhea is systemic dissemination resulting in skin pustules or petechia, septic arthritis, meningitis, or endocarditis. This occurs in between 0.6 and 3% of infected women and 0.4 and 0.7% of infected men.In men, inflammation of the epididymis, prostate gland, and urethra can result from untreated gonorrhea. In women, the most common result of untreated gonorrhea is pelvic inflammatory disease. Other complications include inflammation of the tissue surrounding the liver, a rare complication associated with Fitz-Hugh–Curtis syndrome; septic arthritis in the fingers, wrists, toes, and ankles; septic abortion; chorioamnionitis during pregnancy; neonatal or adult blindness from conjunctivitis; and infertility. Men who have had a gonorrhea infection have an increased risk of getting prostate cancer.
Onset: The onset of gonorrhea symptoms typically appears within 2 to 14 days after exposure to the Neisseria gonorrhoeae bacteria, though some people may be asymptomatic. Symptoms can include painful urination, increased vaginal or penile discharge, and genital itching or soreness.
Prevalence: Gonorrhea, a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae, has a prevalence that varies significantly by region. According to the World Health Organization (WHO), there are approximately 87 million new cases of gonorrhea each year worldwide. The prevalence tends to be higher in low- and middle-income countries, particularly in sub-Saharan Africa, Southeast Asia, and Latin America. It's important to note that many cases go unreported due to lack of access to healthcare and underdiagnosis.
Epidemiology: About 88 million cases of gonorrhea occur each year, out of the 448 million new cases of curable STI each year – that also includes syphilis, chlamydia and trichomoniasis. The prevalence was highest in the African region, the Americas, and Western Pacific, and lowest in Europe. In 2013, it caused about 3,200 deaths, up from 2,300 in 1990.In the United Kingdom, 196 per 100,000 males 20 to 24 years old and 133 per 100,000 females 16 to 19 years old were diagnosed in 2005. In 2013, the CDC estimated that more than 820,000 people in the United States get a new gonorrheal infection each year. Fewer than half of these infections are reported to CDC. In 2011, 321,849 cases of gonorrhea were reported to the CDC. After the implementation of a national gonorrhea control program in the mid-1970s, the national gonorrhea rate declined from 1975 to 1997. After a small increase in 1998, the gonorrhea rate has decreased slightly since 1999. In 2004, the rate of reported gonorrheal infections was 113. 5 per 100,000 persons.In the US, it is the second-most-common bacterial sexually transmitted infections; chlamydia remains first. According to the CDC African Americans are most affected by gonorrhea, accounting for 69% of all gonorrhea cases in 2010.The World Health Organization warned in 2017 of the spread of untreatable strains of gonorrhea, following analysis of at least three cases in Japan, France and Spain, which survived all antibiotic treatment.
Intractability: Gonorrhea is not considered intractable. It is a bacterial infection caused by Neisseria gonorrhoeae and can typically be treated effectively with antibiotics. However, some strains have developed resistance to multiple drugs, making treatment more complex. Early diagnosis and appropriate antibiotic therapy are crucial for effective management.
Disease Severity: Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae.

- **Disease Severity:** Gonorrhea can range from mild to severe. Many individuals are asymptomatic, especially women, but if left untreated, it can lead to serious health complications such as pelvic inflammatory disease (PID) in women, which can result in infertility. In men, untreated gonorrhea can cause epididymitis, potentially leading to infertility as well. The infection can also spread to the blood or joints, causing disseminated gonococcal infection (DGI), which can be life-threatening.

- **Nan:** This term is not relevant to gonorrhea; it is a bacterially caused STD and does not involve nanoscale entities.
Healthcare Professionals: Disease Ontology ID - DOID:7551
Pathophysiology: Pathophysiology of gonorrhea involves the bacterium Neisseria gonorrhoeae, which primarily infects the mucous membranes of the urogenital tract, but can also affect the rectum, pharynx, and eyes. The bacteria adhere to and penetrate epithelial cells, triggering an inflammatory response. This results in symptoms such as purulent discharge and discomfort. If untreated, gonorrhea can lead to complications like pelvic inflammatory disease (PID) in women, epididymitis in men, and potentially disseminated gonococcal infection, leading to systemic involvement including dermatitis, tenosynovitis, and septic arthritis.
Carrier Status: Carrier status for gonorrhea: Individuals infected with gonorrhea can carry the Neisseria gonorrhoeae bacteria without showing symptoms, making them asymptomatic carriers. These individuals can still transmit the infection to others through sexual contact.
Mechanism: Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. Its mechanism of infection involves several key stages:

1. **Adherence**: N. gonorrhoeae adheres to the epithelial cells of the genital tract, urethra, or other mucosal surfaces. This adherence is facilitated by pili and outer membrane proteins such as Opa proteins.

2. **Invasion**: After initial adherence, the bacteria invade the host cells. They use a type IV secretion system to translocate effectors into host cells, which helps in cellular invasion and immune evasion.

3. **Immune Evasion**: N. gonorrhoeae avoids the host immune system through several strategies:
- **Antigenic Variation**: The bacterium frequently changes its surface proteins (e.g., pili and Opa proteins), making it difficult for the immune system to recognize and attack it.
- **Phase Variation**: The reversible on-off switching of the expression of surface proteins also helps in evading the immune response.
- **IgA Protease Production**: The bacterium produces enzymes that degrade Immunoglobulin A (IgA), an antibody involved in mucosal immunity.

4. **Inflammation and Damage**: The presence of N. gonorrhoeae induces inflammation and recruits immune cells to the site of infection. The bacteria release lipooligosaccharides (LOS), which trigger a strong inflammatory response, often causing tissue damage and the symptoms associated with gonorrhea.

Understanding these molecular mechanisms is crucial for developing new treatments and vaccines for gonorrhea.
Treatment: Gonorrhea is typically treated with antibiotics. The current recommended treatment regimen is a single intramuscular injection of 500 mg of ceftriaxone. Additionally, if chlamydia infection has not been excluded, oral doxycycline (100 mg twice daily for 7 days) is also advised. It is crucial for sexual partners to be treated as well to prevent reinfection and further transmission.
Compassionate Use Treatment: Compassionate use treatment and off-label or experimental treatments for gonorrhea are considered when standard therapies are ineffective or unavailable. Here are some options:

1. **Solithromycin**: A newer macrolide antibiotic that has been investigated for treating gonorrhea, though not yet widely approved.
2. **Gepotidacin**: An investigational antibiotic with a novel mechanism of action, showing promise against drug-resistant strains of gonorrhea.
3. **Zoliflodacin**: Another experimental antibiotic that targets DNA synthesis in bacteria, currently under clinical trials.

These treatments are generally considered when dealing with multidrug-resistant Neisseria gonorrhoeae or in cases where patients cannot tolerate standard antibiotics. Decisions should be made by healthcare professionals based on individual patient circumstances and emerging clinical evidence.
Lifestyle Recommendations: For managing and preventing gonorrhea, consider the following lifestyle recommendations:

1. **Safe Sexual Practices**: Use condoms consistently and correctly during sexual activity to reduce the risk of transmission.
2. **Regular Testing**: Get regularly tested for sexually transmitted infections (STIs) if you are sexually active, especially if you have multiple partners.
3. **Monogamous Relationships**: Maintain a mutually monogamous relationship with a partner who has tested negative for STIs.
4. **Communication**: Have open and honest discussions with sexual partners about STI testing and sexual health.
5. **Avoiding Alcohol and Drugs**: Limit alcohol and drug use before sexual activity to make safer decisions.
6. **Seek Treatment Promptly**: If diagnosed with gonorrhea, follow the prescribed treatment regimen fully and ensure sexual partners are informed and treated.

Implementing these recommendations can help manage health and reduce the spread of gonorrhea.
Medication: The standard medications for treating gonorrhea typically include antibiotics such as ceftriaxone, administered as an injection, often in combination with oral azithromycin. It's crucial to follow the prescribed regimen completely to ensure the infection is fully eradicated and to reduce the chance of developing antibiotic-resistant strains.
Repurposable Drugs: Gonorrhea is primarily treated with antibiotics; however, due to rising antibiotic resistance, researchers are exploring various options, including repurposable drugs. No specific repurposable drugs are currently well-established for gonorrhea treatment, but researchers are investigating a range of existing medications for their potential use.

For more definitive treatment, the CDC recommends a dual therapy approach:
1. Ceftriaxone (a third-generation cephalosporin) administered as a single intramuscular injection.
2. Often combined with oral azithromycin.

These recommendations are subject to change based on emerging resistance patterns. Always consult with healthcare professionals for current treatment guidelines.
Metabolites: Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. When the infection occurs, it primarily affects mucous membranes, including the urogenital tract, throat, and rectum. The key metabolites involved in the pathogenic process of gonorrhea include lipooligosaccharide (LOS), which is part of the bacterial outer membrane and can provoke a strong immune response. Additionally, the bacterium significantly consumes and alters the levels of essential host nutrients such as iron and glucose to sustain its growth and pathogenicity. Detailed metabolic profiling specific to gonorrhea might include various host and bacterial metabolites altered due to infection and immune response, but specific plasma or tissue metabolite data are limited.
Nutraceuticals: As of now, nutraceuticals are not a primary treatment for gonorrhea. The standard treatment involves antibiotics prescribed by a healthcare professional. There is ongoing research into the use of nanotechnology for treating bacterial infections, but it is not yet an established or approved method for gonorrhea. For effective management and treatment, consulting with a healthcare provider is essential.
Peptides: Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium *Neisseria gonorrhoeae*. It primarily affects the mucous membranes of the urethra, cervix, rectum, and throat. Symptoms in men may include a burning sensation during urination and discharge from the penis, while women may experience increased vaginal discharge, bleeding between periods, and painful urination. Complications can arise if left untreated, such as pelvic inflammatory disease (PID) in women and epididymitis in men, which can lead to infertility. Antibiotic treatment is effective, but antibiotic-resistant strains are becoming more common, necessitating ongoing research for new treatments.