A sexually or vertically transmitted bacterial infection caused by Neisseria gonorrhoeae:
- Asymptomatic carrier states occur in men and women (more often in women) (1).
- System(s) affected: cardiovascular, musculoskeletal, nervous, reproductive, skin/exocrine
- Synonym(s): gonococcal infection; clap
- Predominant age: 15- to 44-year-olds account for 92% of cases; highest rate among those aged 20 to 24 years
- Predominant sex: men 213/100,000; women 146/100,000
Centers for Disease Control and Prevention (CDC) 2020: 677,769 reported cases
Etiology and Pathophysiology
Infection requires four steps: (i) mucosal attachment—bacterial proteins bind to receptors on host cells, (ii) local penetration/invasion, (iii) local proliferation, (iv) inflammatory response or dissemination. N. gonorrhoeae spreads most commonly through sexual contact.
Deficiency of late components of complement cascade (C7–C9) predisposes to disseminated disease.
- History of previous gonorrhea infection or other STIs
- Age ≤25 years
- Sexual exposure to an infected individual without appropriate use of barrier protection (condom)
- New/multiple sexual partners
- Men who have sex with men (MSM)
- Inconsistent condom use
- Commercial sex work or drug use
- Infants: infected mother
- Children: sexual abuse by infected individual
- Autoinoculation (finger to eye)
- Condoms offer partial protection and must be used appropriately during oral, anal, and vaginal sex.
Commonly Associated Conditions
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