ophthalmic manifestations

1. Gonorrhea (PI D)
Dr.VINIT KUMAR
SCEH,LAHAN

2. male & female reproductive system

3. Outline
• Introduction
• Risk factors
• Symptoms &
signs
• Diagnosis
• Treatment
• Follow up

4. • Gonorrhea is a common sexually transmitted infection (STI).
• A person can transmit it during any kind of sexual contact.
• With an early diagnosis, effective treatment is usually available.
• However, without treatment, gonorrhea can result in long-term complications.

5. • Gonorrhea is usually easy to treat, but delaying treatment can result in serious,
and sometimes permanent, complications.
• PID / pelvic inflammatory disease occurs in females when the gonorrhea
infection affects the uterus or fallopian tubes, and this can lead to infertility.
• Possible complications in males with gonorrhea include epididymitis, which is
inflammation of the tube that carries sperm. This problem, too, can result in
infertility.

6. • Many people with gonorrhea do not notice any symptoms.
• Those who do experience symptoms may have a burning sensation during
urination.
• Males may also notice:
a white, green, or yellow discharge from the penis
pain or swelling in the testicles
inflammation or swelling of the foreskin

7. • Rectal symptoms may also occur if a person has anal sex. These may include:
discharge
itching around the anus
soreness
bleeding
pain during bowel movements
• If gonorrhea results from oral sex, the person may have a throat infection, but
they might not notice any symptoms.
• If infected semen or vaginal fluid enters the eye, the person may develop
conjunctivitis.

8. Gonorrhea can also affect these parts of the body:
1. Rectum. Signs and symptoms include anal itching, pus-like discharge from the
rectum, spots of bright red blood on toilet tissue and having to strain during bowel
movements.
2. Eyes. Gonorrhea that affects your eyes can cause eye pain, sensitivity to light, and
pus-like discharge from one or both eyes.
3. Throat. Signs and symptoms of a throat infection might include a sore throat and
swollen lymph nodes in the neck.
4. Joints. If one or more joints become infected by bacteria (septic arthritis), the
affected joints might be warm, red, swollen and extremely painful, especially
during movement.

9. • Causes
• Gonorrhea is caused by the bacterium Neisseria gonorrhoeae.
• The gonorrhea bacteria are most often passed from one person to another
during sexual contact, including oral, anal or vaginal intercourse.

10. • Risk factors
• Sexually active women younger than 25 and men who have sex with men are at
increased risk of getting gonorrhea.
• Other factors that can increase your risk include:
• Having a new sex partner
• Having a sex partner who has other partners
• Having more than one sex partner
• Having had gonorrhea or another sexually transmitted infection

11. complications
1. Infertility in women. Gonorrhea can spread into the uterus and
fallopian tubes, causing pelvic inflammatory disease (PID). PID
can result in scarring of the tubes, greater risk of pregnancy
complications and infertility..

12. Complications
2.Infertility in men. Gonorrhea can cause a small, coiled tube in the rear portion
of the testicles where the sperm ducts are located (epididymis) to become inflamed
(epididymitis). Untreated epididymitis can lead to infertility.

13. 3. Infection that spreads to the joints and other areas of your body. The bacterium
that causes gonorrhea can spread through the bloodstream and infect other parts of
your body, including your joints. Fever, rash, skin sores, joint pain, swelling and
stiffness are possible complications .

14. 4. Increased risk of HIV/AIDS. Having gonorrhea makes you more susceptible to
infection with human immunodeficiency virus (HIV), the virus that leads to AIDS.
People who have both gonorrhea and HIV are able to pass both diseases more
readily to their partners.

15. 5 . Complications in babies. Babies who contract gonorrhea from their mothers
during birth can develop blindness, sores on the scalp and infections

16. Prevention
To reduce your gonorrhea risk:
1. Use a condom if you have sex .
2. Limit your number of sex partners
3. Be sure you and your partner are tested for sexually transmitted infections
4. Don't have sex with someone who appears to have a sexually transmitted infection
5. Consider regular gonorrhea screening. Annual screening is recommended for sexually active women
younger than 25 and for older women at increased risk of infection. This includes women who have a
new sex partner, more than one sex partner, a sex partner with other partners, or a sex partner who has
a sexually transmitted infection.

19. Introduction
• It is bacterial infection caused by Neisseria
gonorrhoeae causes urogenital, anorectal,
conjunctival, and pharyngeal infections.
• Urogenital tract infections are most common.
• It is second most frequently reported bacterial sexually
transmitted infection (STI) after Chlamydia trachomatis.
• Coinfection with C. trachomatis is common.

21. Screening
• Routine screening for gonorrhea and other curable STIs
should be performed at least annually in sexually active
patients with HIV infection.
• Screening for urethral infections should be performed
with urine nucleic acid amplification testing, whereas
rectal or pharyngeal screening should be performed
with nucleic acid amplification swab.

22. Screening
• Screening every three to six months also is
recommended for men who have sex with men if they
have multiple because they are at highest risk of
contracting STIs.
• Uninfected pregnant women who remain at high risk
should be tested during the third trimester.

24. Infection inwomen
• More than 95% of women with gonorrhea have no symptoms.
• If symptoms occur, they are usually mild, and may mimic acute
cystitis or vaginitis.
• The most common manifestation is cervicitis, which usually
occurs 5-10 day after exposure.
• 10-20% of women with cervical gonorrhea also have a
pharyngeal infection.

25. Infection inwomen
• Untreated gonorrhea causes 10 – 20% of PID cases, and 15
percent of women with PID develop infertility from tubal
scarring.
• CDC recommends that symptomatic women be examined for
PID by palpating for cervical or adnexal tenderness, and
tested for gonorrhea, chlamydia, bacterial vaginosis, and
trichomoniasis with
oendocervical swabs for light microscopy
oand nucleic acid amplification testing.

26. Infection inmen
• Men with gonorrhea usually are symptomatic, but asymptomatic
urethral infections may occur in at least 10 % of cases.
• Symptoms typically appear 2-5 days after infection, but may
take as long as 30 days to appear.
• Common signs and symptoms include dysuria and
purulent penile discharge.
• Unilateral epididymitis without discharge also may be present.

27. Infection inmen
• Chlamydia causes 15-40 % of non-gonococcal
urethritis cases in men.
• 1-2 % of men who have non-gonococcal urethritis develop
sexually acquired reactive arthritis.

28. Infections inInfants
• It can occur in neonates from exposure to infected cervical
secretions during delivery.
• neonatal conjunctivitis (Treatment is important to prevent globe
perforation
and blindness)
• Arthritis
• pharyngitis, rhinitis rarely pneumonia
• vaginitis, urethritis
• localized scalp infections or abscesses
• Sepsis and Meningitis

29. Laboratorydiagnoses
• Gram stain of a urethral smear or cervical swab
showing gram- negative intracellular diplococci.
• Urine nucleic acid amplification testing in women and
men (and urine polymerase chain reaction testing in
men) has comparable sensitivity and specificity to
cervical and urethral samples.

30. Treatment
• Patients’ sex partners within 60 days before symptom
onset should also be treated.
• Fluoroquinolones are not recommended in the United
States for treatment of gonorrhea or associated
conditions because of the emergence of quinolone-
resistant N. gonorrhoeae

32. Followup
• Retesting men and women is recommended three to six
months after treatment, regardless of partner treatment,
because of high rates of reinfection within six months of
therapy
• Pregnant women with first-trimester gonococcal infection
should be retested within three to six months, in addition
to routine test of cure, preferably in the third trimester.
• Uninfected pregnant women who remain at high risk
should be retested during the third trimester.

33. • All patients who test positive for gonorrhea should be
tested for other STIs, including chlamydia, syphilis, and
HIV.

34. THANX