Is gonococcus serious?

Neisseria gonorrhoeae is the causative agent of gonorrhea. Gonococcal infection usually manifests as redness, swelling and itching of the urethra, or in severe cases, mild swelling, leading to difficulty in urination. Gonorrhea is a disease that is neither minor nor serious. It can be cured through medication in the early stages. If it is serious, you should see a doctor as soon as possible and use medication appropriately according to the doctor's diagnosis. So is it serious to have gonococci? Let’s take a look at it together!

【Gonorrhea manifestations】

1. The urethral opening is red, swollen, itchy and slightly stinging, followed by the discharge of thin mucus. In severe cases, there is mild swelling, causing difficulty in urination.

2. After 24 hours, the redness and swelling spread to the entire male genital head and part of the urethra, and the mucous secretions of the urethra gradually increase and overflow from the urethral opening.

3. After a few days of infection, gonorrhea invades the entire anterior urethra, and pus flows to the urethral opening and overflows.

4. Due to the continuous stimulation of the urethral opening by a large amount of gonococcal infection and pus, the urethral opening is formed. Use your hands to squeeze from the base of the male genitals to the urethral opening to squeeze out the pus or mucus.

5. The lymph nodes on both sides may be slightly swollen and tender.

6. Urethral pain may be mild or severe, and the pain worsens with urination, especially at the beginning of urination. Due to pain during urination, people are afraid to urinate, resulting in interrupted urination.

7. The male genitals often become erect due to pain. The male genitals are slightly bent and slightly painful, which is different from erection. It is also accompanied by inguinal lymphadenitis, groin pain, swollen inguinal lymph nodes, and tenderness. Complications such as acute prostatitis, acute seminal vesiculitis, acute epididymitis, and acute eczema may occur.

8. There may be symptoms such as low back pain, back pain, severe pain in the perineum and epididymis, pain during ejaculation, and even hematospermia. Severe cases may be accompanied by whole body chills and fever.

【II】Drugs for the treatment of gonococci

① Third-generation cephalosporins such as ceftriaxone, ceftriaxone and cefixime are highly effective in treating gonorrhea, including infections caused by PPNG and chromosome-mediated penicillin-resistant strains. Foreign studies have shown that gonococci in the urogenital tract (urine, urethral mucosa and semen) can be eliminated within 24 hours after intramuscular injection of 250 mg of ceftriaxone; a single intramuscular injection of 125 mg of ceftriaxone can also maintain a highly effective bactericidal concentration in the blood, and can cure 99.1% of uncomplicated gonococcal infections in the urogenital tract and anorectum. The advantages of ceftriaxone are its long plasma half-life, few and mild side effects, and it can be safely used in pregnant women and newborns. In addition, ceftriaxone is highly effective in treating pharyngeal gonococcal infections; it has a killing effect on Haemophilus ducreyi; it has an anti-Treponema pallidum effect and has a certain effect on possible co-existing latent syphilis; and it is effective against strains resistant to spectinomycin. However, a very small number of patients who are allergic to penicillin may experience allergic reactions. Intravenous cephalosporin regimens are recommended for initial treatment of disseminated gonococcal infection (DGI). This approach is particularly important when gonorrhea is detected at a mucosal site by non-culture methods. It is worth noting that there have been reports of a decrease in the sensitivity of gonococci to third-generation cephalosporins. It is very important to monitor the resistance of gonococci to cephalosporins in clinical practice.

② Spectinomycin is an aminoglycoside antibiotic with broad-spectrum antibacterial activity against both Gram-positive and Gram-negative bacteria. It is mainly or exclusively used to treat gonorrhea. A single dose of 2 g of spectinomycin injected intramuscularly is very effective for uncomplicated gonococcal infections of the urogenital tract and anorectal tract, including PPNG, with a cure rate of 98.2%. Spectinomycin generally has no allergic reaction and no skin test is required before injection. It has few side effects, good safety, and can be used in pregnant women. Spectinomycin is an appropriate drug when the patient is allergic to β-lactam antibiotics, cephalosporins cannot be used, or quinolones are contraindicated for the patient (liver and kidney dysfunction, pregnancy, children and adolescents under 18 years old). Foreign authors have conducted a comparative study on three drugs recommended for the treatment of gonorrhea during pregnancy (penicillin, spectinomycin and ceftriaxone). However, its efficacy for pharyngeal gonococcal infection is poor and it is generally not recommended for use in this setting.