clinical features of gonorrhoea

Last reviewed 01/2018

Symptoms are present in the majority of affected men (90-95%) but only 50% of women (1).

Clinical features in men:

  • genital tract infections
    • usually present within 2-5 days with urethritis characterised by urethral discharge (>80%) and/or dysuria (>50%)
    • may be asymptomatic in <10%
    • urethral discharge is usually described as mucopurulent or purulent
  • rectal infection
    •  is asymptomatic in majority but anal discharge (12%) or perianal/anal pain or discomfort (7%) may be seen in some patients (2)
  • pharyngeal infection
    • is usually asymptomatic in more than 90% (2)
  • rarely, epididymal tenderness/swelling or balanitis is seen on examination

Clinical features in women:

  • genital tract infection
    • increased or altered vaginal discharge is seen in up to 50% of infected females.
    • mucopurulent endocervical discharge and easily induced endocervical bleeding (<50%)
    • lower abdominal pain - in up to 25%
    • pelvic/lower abdominal tenderness in <5%
    • intermenstrual bleeding  or menorrhagia (1)
    • urethral infection may cause dysuria (12%) but not frequency
    • there may be bartholinitis
  • rectal infections
    • frequently develops by transmucosal spread of infected genital secretions than from anal intercourse
    • usually asymptomatic
  • pharyngeal infection
    • is usually asymptomatic in more than 90% (2)

Although uncommon patients may have features of complications of gonorrhoea:

  • epididymo-orchitis or prostatitis in men and pelvic inflammatory disease (PID) in women.
  • disseminated gonococcal infection causes arthralgia, arthritis, tenosynovitis(1), fever, malaise, myalgia and a diffuse pustular and erythematous rash.

Reference:

Related pages:

dysuria

frequency (urinary)

Bartholin's abscess

urethritis