Sexually Transmitted Diseases (STDs in Men) (cont.)

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What is gonorrhea?

Gonorrhea is an STD that is caused by the bacteria Neisseria gonorrhea. In women, this infection often causes no symptoms and can therefore often go undiagnosed. In contrast, men usually have the symptoms of urethritis, burning on urination, and penile discharge. Gonorrhea can also infect the throat (pharyngitis) and the rectum (proctitis). Proctitis results in diarrhea (frequent bowel movements) and an anal discharge (drainage from the rectum). Gonorrhea can also cause epididymitis and orchitis. What is more, gonorrhea can cause systemic disease (throughout the body) and most commonly results in swollen and painful joints or skin rash. Many patients with gonorrhea also are infected with chlamydia.

Symptoms of gonorrhea usually develop in men within 4 to 8 days after genital infection, although in some cases they may occur after a longer time period.

How is gonorrhea diagnosed?

Gonorrhea may be diagnosed by demonstration of the characteristic bacteria when urethral secretions are examined microscopically. Gonorrhea can also be diagnosed by a culture from the infected area, such as the urethra, anus, or throat. In patients with systemic gonorrhea with, for example, arthritis or skin involvement, the organism can occasionally be cultured from the blood. Newer, rapid diagnostic tests that depend upon the identification of the genetic material of N. gonorrhoeae are also available. Gonorrhea and Chlamydia can now be diagnosed with a urine sample.

How is gonorrhea treated?

The treatment of uncomplicated gonorrhea affecting the urethra or rectum is ceftriaxone by IM (intramuscular) injection in a single dose or a single oral dose of cefixime (Suprax). An intramuscular injection of spectinomycin (not available in the U.S.) is also an alternative treatment. Single doses of other cephalosporins such as ceftizoxime, cefoxitin, administered with probenecid (Benemid), or cefotaxime have also been used to treat gonorrhea.

Many persons with gonorrhea are simultaneously infected with chlamydia. Those treated for gonorrhea, therefore, should also be treated for chlamydia with azithromycin or doxycycline, both of which are taken by mouth. Throat infection (pharyngitis) caused by gonorrhea is somewhat more difficult to treat than genital infection. The recommended antibiotic for treatment of gonococcal pharyngitis is a single IM injection of ceftriaxone IM.

Systemic gonorrheal infections involving the skin and/or joints is generally treated with either daily injections of ceftriaxone in the muscle tissue (intramuscularly) or in the vein (intravenously) every 24 hours, or ceftizoxime intravenously every 8 hours. Another option for the treatment of disseminated (throughout the body) gonococcal infections is spectinomycin (not available in the U.S.) intramuscularly every 12 hours.

Because of increasing resistance to these drugs, the fluoroquinolone antibiotics (such as ofloxacin [Floxin] and ciprofloxacin [Cipro]) are no longer recommended for treatment of gonococcal infections in the U.S.

What should a person do if exposed to someone with gonorrhea?

A person who is sexually exposed to an individual that is infected with gonorrhea should seek medical attention. If the last sexual contact was within 60 days of the partner's diagnosis, the person should be treated for both gonorrhea and Chlamydia. People whose last sexual contact was more than 60 days before the partner's diagnosis should be evaluated for symptoms and have diagnostic studies performed. Treatment for individuals whose exposure was relatively in the more distant past should be limited to those who have symptoms or positive diagnostic tests.

Medically Reviewed by a Doctor on 10/16/2014

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Sexually Transmitted Diseases in Men - HPV Question: Have you or your partner been diagnosed with HPV (genital warts)? Please share your experience.
Sexually Transmitted Diseases in Men - Chlamydia Question: Were you ever diagnosed with chlamydia? What were your symptoms and treatment?