Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. It is one of the most common infectious diseases in the world; after nongonococcal urethritis (see next page), it is the most common STD, infecting 1 million to 3 million Americans each year. Gonorrhea occurs most often among young adults with multiple sexual partners.
Following a short incubation period of 2 to 10 days, men who have been infected with gonorrhea typically develop discomfort in the urethra. This pro- gresses to pain on urination and a discharge of pus from the penis; the urge to urinate is frequent and urgent, and the opening of the penis may become red and swollen. Gonorrhea acquired during oral or anal sex is not likely to produce symptoms. Symptoms that do occur include a sore throat (from oral sex) and pain in and discharge from the anus (from anal sex).
As a bacterial disease, gonorrhea can be treated with antibiotics, either with a single injection or a week-long course of oral medication. If gonorrhea has spread through the bloodstream, the antibiotics are given intravenously, which sometimes requires hospitalization. Many people with gonorrhea also have chlamydia (see page 183) so they should be tested for both.
Because gonorrhea is highly contagious, and because women who are exposed to it may not develop symptoms for weeks or months, it is important for people who are infected to identify and notify all previous sexual partners. Many clinics have special counselors, called contact tracers, who can help with this process.
Untreated gonorrhea may spread to other parts of the body, including the prostate and the testicles. Inﬂammation of either organ may cause infertility. (Like chlamydia, gonorrhea is a major cause of pelvic inﬂammatory disease in women, who may become infertile as a result.) If ﬂuids infected with the bac- terium come into contact with the eyes, the result may be gonorrheal conjunc- tivitis, an eye infection that, if left untreated, can lead to blindness. A different kind of eye infection may affect infants born to infected mothers.
Gonococcal arthritis, causing joint pain and swelling, can occur when gonor- rhea spreads through the bloodstream. However, this condition is rare. Sep- ticemia (commonly known as blood poisoning) is a potentially fatal disorder involving high fever, chills, headaches, and clouding of consciousness. It is another rare complication of bloodborne gonorrhea.