Gonorrhea

Gonorrhea is a sexually transmitted infection caused by Neisseria gonorrhoeae, a Gram-negative diplococcus that infects the mucous membranes of the urethra, cervix, rectum, pharynx and conjunctiva. The bacterium attaches to mucosal cells and triggers a neutrophil-rich inflammatory response. That response explains the purulent discharge of symptomatic infection and the classic Gram stain finding of Gram-negative intracellular diplococci inside white blood cells. Spread upward from the cervix causes pelvic inflammatory disease (PID); spread along the male genital tract causes epididymo-orchitis. Rarely, the bacteria enter the bloodstream and cause disseminated gonococcal infection (DGI). Transmission occurs through vaginal, anal or oral sexual contact, and from a birthing parent to the newborn during vaginal delivery when infection has not been treated. The incubation period is usually 2 to 7 days but ranges from 1 to 14 days. Treatment cures the current infection but does not create immunity, so a person can be reinfected at the next exposure. Coinfection with Chlamydia trachomatis is common. Gonorrhea is the second most commonly reported STI in Canada. In 2021, 32,192 cases were reported, a rate of 84.2 per...