The incubation period is 10 to 20 days with most symptoms occurring between the fifteenth and twentieth days after being infected. A small number of people may be asymptomatic for up to a lifetime. Between 30% and 60% of people with gonorrhea are asymptomatic or have subclinical disease.[4] Women may complain of vaginal discharge, difficulty urinating (dysuria), projectile urination, off-cycle menstrual bleeding, or bleeding after sexual intercourse. The cervix may appear anywhere from normal to the extreme of marked cervical inflammation with pus. Possibility of increased production of male hormones is common in many cases. Infection of the urethra (urethritis) causes little dysuria or pus. The combination of urethritis and cervicitis on examination strongly supports a gonorrhea diagnosis, as both sites are infected in most gonorrhea patients. Gonorrhea is caused by the Neisseria gonorrhoeae bacteria. The infection is transmitted from one person to another through vaginal, oral, or anal sexual relations, though transmission occurs rarely with safe sex practices of condom usage with lubrication.
Men have a 20% risk of getting the infection by having sexual relations with a woman infected with gonorrhea. Women have a 50% risk of getting the infection by having sexual relations with a man infected with gonorrhea. An infected mother may transmit gonorrhea to her newborn during childbirth, a condition known as ophthalmia neonatorum.[5]
Less advanced symptoms, which may indicate development of pelvic inflammatory disease (PID), include cramps and pain, bleeding between menstrual periods, vomiting, or fever. It is not unusual for men to have asymptomatic gonorrhea. Men may complain of pain on urinating and thick, copious, urethral pus discharge (also known as gleet) is the most common presentation. Examination may show a reddened external urethral meatus. Ascending infection may involve the epididymis, testicles or prostate gland causing symptoms such as scrotal pain or swelling. Instances of blurred vision in one eye may occur in adults.
GC infection can also present as septic arthritis.
[edit] Complications
In men, inflammation of the epididymis (epididymitis), prostate gland (prostatitis) and urethral structure (urethritis) can result from untreated gonorrhea[5].
In women, the most common result of untreated gonorrhea is pelvic inflammatory disease, a serious infection of the uterus that can lead to infertility. Other complications include: perihepatitis,[5] 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.
The underlying gonorrhea should be treated; if this is done then usually a good prognosis will follow.
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