Materiały źródłowe

• #1 Gonorrhea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gonorrhea/diagnosis-treatment/drc-20351780

  You may be able to use a test that’s available without a prescription, sometimes called an at-home test, to see if you have gonorrhea. If that test shows you have gonorrhea, you’ll need to see a healthcare professional to confirm the diagnosis and start treatment. […] To determine whether you have gonorrhea, your healthcare professional will analyze a sample of cells. Samples can be collected with: […] A urine test. This can help identify bacteria in your urethra. […] A swab of the affected area. A swab of your throat, urethra, vagina or rectum can collect bacteria that can be identified in a lab. […] Your healthcare professional may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. […] Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for other sexually transmitted infections could be beneficial as well.

• #2 About Gonorrhea | Gonorrhea | CDC

  https://www.cdc.gov/gonorrhea/about/index.html

  Gonorrhea is an STI that can cause infection in the genitals, rectum, and throat. It is very common, especially among young people ages 15-24 years. […] Gonorrhea often has no symptoms, but it can cause serious health problems, even without symptoms. […] If you are sexually active, have an honest and open talk with your healthcare provider. Ask them if you should get tested for gonorrhea or other STIs. […] Most of the time, a healthcare provider will use a urine sample to diagnose gonorrhea. However, if you have had oral and/or anal sex, your healthcare provider may use swabs to collect samples from your throat and/or rectum. In some cases, a healthcare provider may also use a swab to collect a sample from a man’s urethra (urine canal) or a woman’s cervix (opening to the womb). […] Yes, the right treatment can cure gonorrhea. It is important that you take all of the medicine your healthcare provider gives you to cure your infection. […] Untreated gonorrhea can cause serious and permanent health problems.

• #3 Gonorrhea Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/gonorrhea-test/

  Gonorrhea is one of the most common sexually transmitted diseases (STDs). It is a bacterial infection. Anyone can get gonorrhea if they have vaginal, oral, or anal sex with someone who has the infection. The bacteria often infect the genitals, but it can infect the rectum, throat, eyes, and other parts of the body. […] A gonorrhea test looks for signs of gonorrhea bacteria in a sample of fluid from your body. The fluid used depends on the type of gonorrhea test and where the infection may be. Samples may include: […] A gonorrhea test can help find the disease early so you can get treatment before you develop lasting health problems or spread it to others. […] A gonorrhea test is used to: […] Diagnose or rule out gonorrhea when you have symptoms. […] If you are sexually active and have symptoms, you need a test to diagnose or rule out gonorrhea. The symptoms of gonorrhea depend on where the infection is. Symptoms include:

• #4 About Gonorrhea | Gonorrhea | CDC

  https://www.cdc.gov/gonorrhea/about/index.html

  Gonorrhea is an STI that can cause infection in the genitals, rectum, and throat. It is very common, especially among young people ages 15-24 years. […] Gonorrhea often has no symptoms, but it can cause serious health problems, even without symptoms. […] If you are sexually active, have an honest and open talk with your healthcare provider. Ask them if you should get tested for gonorrhea or other STIs. […] Most of the time, a healthcare provider will use a urine sample to diagnose gonorrhea. However, if you have had oral and/or anal sex, your healthcare provider may use swabs to collect samples from your throat and/or rectum. In some cases, a healthcare provider may also use a swab to collect a sample from a man’s urethra (urine canal) or a woman’s cervix (opening to the womb). […] Yes, the right treatment can cure gonorrhea. It is important that you take all of the medicine your healthcare provider gives you to cure your infection. […] Untreated gonorrhea can cause serious and permanent health problems.

• #5 Gonorrhea: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/4217-gonorrhea

  Gonorrhea is a common sexually transmitted infection (STI) that comes from a bacteria called Neisseria gonorrhoeae (N. gonorrhoeae). […] If you believe you have gonorrhea, dont wait to seek treatment. Untreated gonorrhea can cause long-term health complications. Your healthcare provider will prescribe antibiotics to clear up a gonorrhea infection. […] Only a healthcare provider can tell you for sure if you have gonorrhea. First, theyll ask you questions about your symptoms and sexual history. Then, your provider will collect a sample of your pee or bodily fluid to check it for the bacteria that causes gonorrhea. […] Youll need antibiotics to treat gonorrhea. Your partner(s) will need treatment, too. […] Gonorrhea infection clears up within seven to 14 days after treatment with antibiotics. Some healthcare providers recommend a second gonorrhea test to make sure the infection is completely gone.

• #6 Gonorrhea Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/gonorrhea-test/

  Gonorrhea is one of the most common sexually transmitted diseases (STDs). It is a bacterial infection. Anyone can get gonorrhea if they have vaginal, oral, or anal sex with someone who has the infection. The bacteria often infect the genitals, but it can infect the rectum, throat, eyes, and other parts of the body. […] A gonorrhea test looks for signs of gonorrhea bacteria in a sample of fluid from your body. The fluid used depends on the type of gonorrhea test and where the infection may be. Samples may include: […] A gonorrhea test can help find the disease early so you can get treatment before you develop lasting health problems or spread it to others. […] A gonorrhea test is used to: […] Diagnose or rule out gonorrhea when you have symptoms. […] If you are sexually active and have symptoms, you need a test to diagnose or rule out gonorrhea. The symptoms of gonorrhea depend on where the infection is. Symptoms include:

• #7 Gonococcal Infections Among Adolescents and Adults – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm

  Specific microbiologic diagnosis of N. gonorrhoeae infection should be performed for all persons at risk for or suspected of having gonorrhea; a specific diagnosis can potentially reduce complications, reinfections, and transmission. […] Culture, NAAT, and POC NAAT, such as GeneXpert (Cepheid), are available for detecting genitourinary infection with N. gonorrhoeae; culture requires endocervical (women) or urethral (men) swab specimens. […] NAAT sensitivity for detecting N. gonorrhoeae from urogenital and nongenital anatomic sites is superior to culture but varies by NAAT type. […] In cases of suspected or documented treatment failure, clinicians should perform both culture and antimicrobial susceptibility testing because NAATs cannot provide antimicrobial susceptibility results. […] Because of its high specificity (99%) and sensitivity (95%), a Gram stain of urethral discharge or secretions that demonstrate polymorphonuclear leukocytes with intracellular gram-negative diplococci can be considered diagnostic for infection with N. gonorrhoeae among symptomatic men. […] Infection detection by using Gram stain of endocervical, pharyngeal, and rectal specimens also is insensitive and is not recommended. […] Gonococcal infection is diagnosed among symptomatic men by documenting the presence of a WBC-containing intracellular purple diplococci in MB or GV smears.

• #8 Gonorrhea Test: What It Is, Purpose, Procedure & Results

  https://my.clevelandclinic.org/health/diagnostics/25211-gonorrhea-test

  Healthcare providers use gonorrhea tests to confirm or rule out this common sexually transmitted infection (STI). A gonorrhea test involves testing a fluid sample from the part of your body that might be infected. Common methods include urine (pee) and swab samples from your genitals, rectum or throat. […] A gonorrhea test can tell you if you have gonorrhea, a common sexually transmitted infection (STI). Testing is an important way to screen for and diagnose the condition so you dont spread it to your partners without knowing it. […] Taking a gonorrhea test is the only way to know if you have this bacterial infection. […] Healthcare providers test your body fluids for the Neisseria gonorrhoeae bacterium. If they detect this bacterium, it means you have gonorrhea. […] The most common gonorrhea testing method is a nucleic acid amplification test (NAAT). NAAT detects the genetic material of the Neisseria gonorrhoeae bacterium.

• #9 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Culture is the gold standard test in the workup of gonorrheal infections. Bacterial culture has high sensitivity and high specificity, is relatively low cost, is suitable for different types of specimen sources, and can be used for epidemiologic and resistance testing purposes. […] Based on CDC guidelines and the USPS Task Force recommendations, nucleic acid amplification test (NAAT) assay is the test of choice to evaluate for urogenital infections in both males and females, whether symptomatic or asymptomatic. […] One benefit of NAAT assay is that it does not require live organisms yet can yield a positive result with minimal genetic material available, using specimens such as first catch urine and vaginal swabs. Sensitivity for detection exceeds 90%, and specificity is 99% or higher.

• #10 Recommendations For the Diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis, Including Extra-Genital Sites

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3763711/

  Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the two most common reportable sexually transmitted infections (STIs) in the United States. Clinicians should be aware of current screening recommendations and diagnostic methods for detection of gonorrhea and chlamydia in genital as well as extra-genital sites to address this prevailing epidemic, particularly among younger women and MSM. […] The current standard laboratory test for detection of urogenital chlamydia and gonorrhea is a nucleic acid amplification test (NAAT). These tests are extremely sensitive and specific for detection of both organisms (90%) using a noninvasive urine sample, thus reducing the need for pelvic examination or urethral sampling. Current guidelines recommend screening all women age 25 years or younger for chlamydia and gonorrhea, as well as women older than 25 who have a history of STIs, new or multiple sex partners, or exchange sex for drugs or money.

• #11 Gonorrhea Test: What It Is, Purpose, Procedure & Results

  https://my.clevelandclinic.org/health/diagnostics/25211-gonorrhea-test

  Healthcare providers use gonorrhea tests to confirm or rule out this common sexually transmitted infection (STI). A gonorrhea test involves testing a fluid sample from the part of your body that might be infected. Common methods include urine (pee) and swab samples from your genitals, rectum or throat. […] A gonorrhea test can tell you if you have gonorrhea, a common sexually transmitted infection (STI). Testing is an important way to screen for and diagnose the condition so you dont spread it to your partners without knowing it. […] Taking a gonorrhea test is the only way to know if you have this bacterial infection. […] Healthcare providers test your body fluids for the Neisseria gonorrhoeae bacterium. If they detect this bacterium, it means you have gonorrhea. […] The most common gonorrhea testing method is a nucleic acid amplification test (NAAT). NAAT detects the genetic material of the Neisseria gonorrhoeae bacterium.

• #12 Gonorrhea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gonorrhea/diagnosis-treatment/drc-20351780

  You may be able to use a test that’s available without a prescription, sometimes called an at-home test, to see if you have gonorrhea. If that test shows you have gonorrhea, you’ll need to see a healthcare professional to confirm the diagnosis and start treatment. […] To determine whether you have gonorrhea, your healthcare professional will analyze a sample of cells. Samples can be collected with: […] A urine test. This can help identify bacteria in your urethra. […] A swab of the affected area. A swab of your throat, urethra, vagina or rectum can collect bacteria that can be identified in a lab. […] Your healthcare professional may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. […] Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for other sexually transmitted infections could be beneficial as well.

• #13 Recommendations For the Diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis, Including Extra-Genital Sites

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3763711/

  Clinicians should be aware of extra-genital mucosal sites of infection for both gonorrhea and chlamydia, specifically the oropharynx and rectum. Although no NAAT tests are FDA-cleared for use with rectal or oropharyngeal specimens for the diagnosis of gonorrhea and chlamydia, some laboratories have validated these specimen sites for clinical use. […] Aggressive STI screening of the oropharynx, rectum, and urethra should be performed in individuals who perform sexual practices involving these sites, especially in MSM. Comprehensive STI screening for chlamydia and gonorrhea should include a NAAT of the urine, rectum (for men and women who have receptive anal intercourse), and the pharynx (for men with gonorrhea and women who have receptive oral intercourse). Recognition and diagnosis of chlamydia and gonorrhea is essential to decrease the morbidity associated with these diseases, as well as prevent the transmission of other STIs including HIV.

• #14 Gonorrhea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gonorrhea/diagnosis-treatment/drc-20351780

  You may be able to use a test that’s available without a prescription, sometimes called an at-home test, to see if you have gonorrhea. If that test shows you have gonorrhea, you’ll need to see a healthcare professional to confirm the diagnosis and start treatment. […] To determine whether you have gonorrhea, your healthcare professional will analyze a sample of cells. Samples can be collected with: […] A urine test. This can help identify bacteria in your urethra. […] A swab of the affected area. A swab of your throat, urethra, vagina or rectum can collect bacteria that can be identified in a lab. […] Your healthcare professional may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. […] Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for other sexually transmitted infections could be beneficial as well.

• #15 Recommendations For the Diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis, Including Extra-Genital Sites

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3763711/

  Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the two most common reportable sexually transmitted infections (STIs) in the United States. Clinicians should be aware of current screening recommendations and diagnostic methods for detection of gonorrhea and chlamydia in genital as well as extra-genital sites to address this prevailing epidemic, particularly among younger women and MSM. […] The current standard laboratory test for detection of urogenital chlamydia and gonorrhea is a nucleic acid amplification test (NAAT). These tests are extremely sensitive and specific for detection of both organisms (90%) using a noninvasive urine sample, thus reducing the need for pelvic examination or urethral sampling. Current guidelines recommend screening all women age 25 years or younger for chlamydia and gonorrhea, as well as women older than 25 who have a history of STIs, new or multiple sex partners, or exchange sex for drugs or money.

• #16 Core Concepts – Gonococcal Infections – Self-Study Lessons – National STD Curriculum

  https://www.std.uw.edu/go/comprehensive-study/gonococcal-infections/core-concept/all

  Gonorrhea is the second most common notifiable sexually transmitted infection (STI) in the United States. This infection is caused by the gram-negative bacterium Neisseria gonorrhoeae and is transmitted through sexual activity or perinatally during vaginal delivery. In the modern era, there are excellent diagnostic tests for gonorrhea. […] The approach to diagnostic testing for N. gonorrhoeae has evolved from traditional cultivation to the widespread use of nucleic acid amplification tests (NAATs. […] The NAATs used for detecting N. gonorrhoeae in the United States include polymerase chain reaction tests (Roche Amplicor and Cepheid GeneXpert CT/NG), transcription-mediated amplification (Gen-Probe Aptima), and strand displacement amplification (Becton-Dickinson BDProbeTec ET). […] A Gram stain is inadequate for evaluating prepubertal children for gonorrhea and should not be used to diagnose or exclude gonorrhea.

• #17 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Culture is the gold standard test in the workup of gonorrheal infections. Bacterial culture has high sensitivity and high specificity, is relatively low cost, is suitable for different types of specimen sources, and can be used for epidemiologic and resistance testing purposes. […] Based on CDC guidelines and the USPS Task Force recommendations, nucleic acid amplification test (NAAT) assay is the test of choice to evaluate for urogenital infections in both males and females, whether symptomatic or asymptomatic. […] One benefit of NAAT assay is that it does not require live organisms yet can yield a positive result with minimal genetic material available, using specimens such as first catch urine and vaginal swabs. Sensitivity for detection exceeds 90%, and specificity is 99% or higher.

• #18 Gonorrhea: Symptoms, Causes, and Treatment

  https://www.verywellhealth.com/gonorrhea-8701014

  Gonorrhea, commonly referred to as „the clap,” is a sexually transmitted infection (STI) that frequently goes undiagnosed and untreated. […] By recognizing the signs of gonorrhea and better understanding your risk of infection you can get tested and seek treatment, often with a single dose of antibiotics. […] Today, the primary form of diagnosis is polymerase chain reaction (PCR). These are tests that can detect genetic evidence of N. gonorrhoeae from either a urine sample or a swab of fluids from the genitals, rectum, or throat. […] PCRs are the preferred method of testing as they are easy to administer and have a high level of accuracy. Their sensitivity is over 90% (meaning it can identify people with a disease 90% or more of the time) and a specificity of 99% or higher (meaning it can identify people without the disease 99% or more of the time).

• #19 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Culture is the gold standard test in the workup of gonorrheal infections. Bacterial culture has high sensitivity and high specificity, is relatively low cost, is suitable for different types of specimen sources, and can be used for epidemiologic and resistance testing purposes. […] Based on CDC guidelines and the USPS Task Force recommendations, nucleic acid amplification test (NAAT) assay is the test of choice to evaluate for urogenital infections in both males and females, whether symptomatic or asymptomatic. […] One benefit of NAAT assay is that it does not require live organisms yet can yield a positive result with minimal genetic material available, using specimens such as first catch urine and vaginal swabs. Sensitivity for detection exceeds 90%, and specificity is 99% or higher.

• #20 The laboratory diagnosis of Neisseria gonorrhoeae

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095009/

  The present article describes the laboratory diagnosis of Neisseria gonorrhoeae by culturing of the organism from different types of clinical specimens followed by confirmatory tests. The success of culture methods requires good quality collection and transport of clinical specimens. Confirmatory tests include biochemical tests, chromogenic enzyme substrate tests, immunoassays and nucleic acid methods. Nucleic acid detection methods include either amplification-based methods or nonamplification tests, and are increasingly used in clinical laboratories where a viable culture is not possible to obtain. […] Monitoring of antimicrobial susceptibilities of N gonorrhoeae is important to investigate treatment failure and to evaluate the efficacy of currently recommended therapies. […] The current preferred laboratory method for the diagnosis of N gonorrhoeae infections is the isolation and identification of the agent. Culturing isolates is important for antimicrobial susceptibility testing, surveillance purposes, detecting treatment failure and characterizing outbreaks.

• #21 The laboratory diagnosis of Neisseria gonorrhoeae

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095009/

  The present article describes the laboratory diagnosis of Neisseria gonorrhoeae by culturing of the organism from different types of clinical specimens followed by confirmatory tests. The success of culture methods requires good quality collection and transport of clinical specimens. Confirmatory tests include biochemical tests, chromogenic enzyme substrate tests, immunoassays and nucleic acid methods. Nucleic acid detection methods include either amplification-based methods or nonamplification tests, and are increasingly used in clinical laboratories where a viable culture is not possible to obtain. […] Monitoring of antimicrobial susceptibilities of N gonorrhoeae is important to investigate treatment failure and to evaluate the efficacy of currently recommended therapies. […] The current preferred laboratory method for the diagnosis of N gonorrhoeae infections is the isolation and identification of the agent. Culturing isolates is important for antimicrobial susceptibility testing, surveillance purposes, detecting treatment failure and characterizing outbreaks.

• #22 The laboratory diagnosis of Neisseria gonorrhoeae

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095009/

  The presumptive identification of N gonorrhoeae rests on the isolation of an oxidase-positive, Gram-negative diplococcus recovered from urogenital sites that grows on selective media. […] Several methods are available to confirm the identification of N gonorrhoeae, including biochemical testing, serological testing, colourimetric testing and nucleic acid methods. More than one system may be required to confirm identification. […] Molecular detection methods allow for a more rapid and specific diagnosis of pathogens that are fastidious or cannot be cultured. Nucleic acid methods developed for sexually transmitted pathogens are rapid, highly sensitive and specific for the detection of these organisms in clinical specimens. […] The nucleic acid tests, especially the semi-automated and automated systems, are less labour intensive than cultural methods and allow high throughput processing of clinical specimens. The processing time for nucleic acid methods is shorter than for cultural methods. […] Identification of N gonorrhoeae requires confirmation using two different methods involving different principles (or different gene targets in nucleic acid detection methods), especially in medicolegal cases.

• #23 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Perform a culture or nonculture detection test for N gonorrhoeae on endocervical, urethral, pharyngeal, or rectal discharge. […] Nonculture tests are less accurate in the presence of blood or during menses. Use culture instead at these times. […] Culture is performed on Thayer-Martin plates that must be stored refrigerated but warmed to room temperature before obtaining a sample. […] Medicolegal cases (eg, child abuse, rape) require culture due to the possibility of false-positive results with nonculture methods. […] Patients with gonococcemia may have an elevated white blood cell (WBC) count, in the range of 10,000-15,000/L. […] The erythrocyte sedimentation rate (ESR) is usually mildly elevated, with values from 20-50 in most patients. […] These tests include latex agglutination, ELISA, immunoprecipitation, and complement fixation tests.

• #24

  https://www.who.int/news-room/fact-sheets/detail/gonorrhoea-(neisseria-gonorrhoeae-infection)

  Molecular tests are the gold standard for diagnosing N. gonorrhoeae which can be performed in the laboratory or at the point of care. […] Rapid diagnostic tests are currently under development. […] Gram stain microscopy is used in some laboratories. However, this method is less sensitive in women with vaginal/cervical discharge as well as for throat and anal infections. […] In many primary health care settings where diagnostic capacity for detecting N. gonorrhoeae is not available, a syndromic approach for case management is recommended. […] Sexual history taking and risk assessment are crucial in evaluating a service user before diagnosis. Clinical examination, speculum examination (in women) and palpation can provide important clues to clinical diagnosis. […] Urine samples (preferred for men) are commonly used for diagnosing gonorrhoea, but swabs (preferred for women) from genital and other sites (anus, throat, conjunctiva) can be used depending on the location of symptoms, sexual practices and medical history.

• #25 Gonorrhea: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/007267.htm

  Gonorrhea can be quickly detected by looking at a sample of discharge or tissue under the microscope after it has been treated with special chemicals. This is called a Gram stain. This method is fast, but it is not the most certain. […] Gonorrhea is most accurately detected with DNA tests. DNA tests are useful for screening. The ligase chain reaction (LCR) test is one of the tests. DNA tests are quicker than cultures. These tests can be performed on urine samples, which are easier to collect than samples from the genital area. […] Prior to DNA tests, cultures (cells that grow in a lab dish) were used to provide proof of gonorrhea, but are less commonly used now. […] Samples for a culture are most often taken from the cervix, vagina, urethra, anus, or throat. Rarely, samples are taken from joint fluid or blood. Cultures can often provide an early diagnosis within 24 hours. A confirmed diagnosis is available within 72 hours.

• #26 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Perform a culture or nonculture detection test for N gonorrhoeae on endocervical, urethral, pharyngeal, or rectal discharge. […] Nonculture tests are less accurate in the presence of blood or during menses. Use culture instead at these times. […] Culture is performed on Thayer-Martin plates that must be stored refrigerated but warmed to room temperature before obtaining a sample. […] Medicolegal cases (eg, child abuse, rape) require culture due to the possibility of false-positive results with nonculture methods. […] Patients with gonococcemia may have an elevated white blood cell (WBC) count, in the range of 10,000-15,000/L. […] The erythrocyte sedimentation rate (ESR) is usually mildly elevated, with values from 20-50 in most patients. […] These tests include latex agglutination, ELISA, immunoprecipitation, and complement fixation tests.

• #27 Gonococcal Infections Among Adolescents and Adults – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm

  Specific microbiologic diagnosis of N. gonorrhoeae infection should be performed for all persons at risk for or suspected of having gonorrhea; a specific diagnosis can potentially reduce complications, reinfections, and transmission. […] Culture, NAAT, and POC NAAT, such as GeneXpert (Cepheid), are available for detecting genitourinary infection with N. gonorrhoeae; culture requires endocervical (women) or urethral (men) swab specimens. […] NAAT sensitivity for detecting N. gonorrhoeae from urogenital and nongenital anatomic sites is superior to culture but varies by NAAT type. […] In cases of suspected or documented treatment failure, clinicians should perform both culture and antimicrobial susceptibility testing because NAATs cannot provide antimicrobial susceptibility results. […] Because of its high specificity (99%) and sensitivity (95%), a Gram stain of urethral discharge or secretions that demonstrate polymorphonuclear leukocytes with intracellular gram-negative diplococci can be considered diagnostic for infection with N. gonorrhoeae among symptomatic men. […] Infection detection by using Gram stain of endocervical, pharyngeal, and rectal specimens also is insensitive and is not recommended. […] Gonococcal infection is diagnosed among symptomatic men by documenting the presence of a WBC-containing intracellular purple diplococci in MB or GV smears.

• #28 Diagnosis and Management of Gonococcal Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1115/p931.html

  Gonorrhea is characterized by Gram stain of a urethral smear or cervical swab showing gram-negative intracellular diplococci. […] Urine nucleic acid amplification testing in women and men (and urine polymerase chain reaction testing in men) has comparable sensitivity and specificity to cervical and urethral samples. […] Treatment of gonococcal infections is outlined in Table 3. […] Ceftriaxone, 250 mg in a single intramuscular injection, plus either azithromycin (Zithromax), 1 g orally, or doxycycline, 100 mg orally twice daily for seven days, is effective for treating uncomplicated cervical, urethral, anorectal, and pharyngeal infections. […] Retesting men and women is recommended three to six months after treatment, regardless of partner treatment, because of high rates of reinfection within six months of therapy. […] The USPSTF recommends routine screening for gonorrhea in all sexually active women at increased risk of infection, including during pregnancy, but recommends against screening low-risk men and women.

• #29 Gonococcal Infections Among Adolescents and Adults – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm

  Specific microbiologic diagnosis of N. gonorrhoeae infection should be performed for all persons at risk for or suspected of having gonorrhea; a specific diagnosis can potentially reduce complications, reinfections, and transmission. […] Culture, NAAT, and POC NAAT, such as GeneXpert (Cepheid), are available for detecting genitourinary infection with N. gonorrhoeae; culture requires endocervical (women) or urethral (men) swab specimens. […] NAAT sensitivity for detecting N. gonorrhoeae from urogenital and nongenital anatomic sites is superior to culture but varies by NAAT type. […] In cases of suspected or documented treatment failure, clinicians should perform both culture and antimicrobial susceptibility testing because NAATs cannot provide antimicrobial susceptibility results. […] Because of its high specificity (99%) and sensitivity (95%), a Gram stain of urethral discharge or secretions that demonstrate polymorphonuclear leukocytes with intracellular gram-negative diplococci can be considered diagnostic for infection with N. gonorrhoeae among symptomatic men. […] Infection detection by using Gram stain of endocervical, pharyngeal, and rectal specimens also is insensitive and is not recommended. […] Gonococcal infection is diagnosed among symptomatic men by documenting the presence of a WBC-containing intracellular purple diplococci in MB or GV smears.

• #30 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Gram stains, cultures, and nucleic acid amplification tests (NAATs) of genital, rectal, conjunctival, pharyngeal secretions and/or other extragenital sites, as applicable, should also be obtained when DGI is suspected. […] The highest yield of N gonorrhoeae organisms in gonococcemia is from mucosal sites, including the pharynx, urethra, cervix, or rectum. […] A negative Gram stain result is not sufficient for excluding neisserial infections in asymptomatic men. […] In women with positive cervical culture results, the Gram stain results from the endocervix are 50-60% sensitive and 82-97% specific. […] The preferred method to screen for genitourinary gonorrhea is collection of vaginal swab specimens sent for NAAT assay testing. […] If the patient needs a concurrent pelvic examination, an endocervical swab is reasonable; however, in contrast with workup in males, first catch urine specimens to detect gonorrhea may detect about 10% fewer infections when compared with vaginal and endocervical swab specimens. […] Extragenital gonorrheal infections (pharyngeal and rectal infections) are often asymptomatic and are not uncommon in certain populations, such as men who have sex with men (MSM).

• #31 Gonorrhea – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/sexually-transmitted-infections-stis/gonorrhea

  Gonorrhea is diagnosed when gonococci are detected via microscopic examination using a nucleic acid-based test, Gram stain, or culture of genital fluids, blood, or joint fluids (obtained by needle aspiration). […] Nucleic acid amplification tests (NAATs) may be done on genital, rectal, or oral swabs and can detect both gonorrhea and chlamydial infection. NAATs further increase the sensitivity adequately to enable testing of urine samples in both sexes. […] Gram stain is sensitive and specific for gonorrhea in men with urethral discharge; gram-negative intracellular diplococci typically are seen. Gram stain is much less accurate for infections of the cervix, pharynx, and rectum and is not recommended for diagnosis at these sites. […] Culture is sensitive and specific, but because gonococci are fragile and fastidious, samples taken using a swab need to be rapidly plated on an appropriate medium (eg, modified Thayer-Martin) and transported to the laboratory in a carbon dioxide-containing environment.

• #32 Gonorrhea guide: Screening and diagnostic testing – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/gonorrhea/screening-diagnostic-testing.html

  NAAT are the most sensitive tests for N. gonorrhoeae and may increase the number of cases diagnosed. […] Although culture is less sensitive than NAAT, it provides antimicrobial susceptibilities, which is important for case management and public health monitoring of antimicrobial resistance (AMR) patterns and trends. […] The presence of Gram-negative intracellular diplococci (GNID) seen on direct microscopic examination of urethral smears is highly predictive of N. gonorrhoeae in symptomatic males.

• #33 Gonococcal Infections Among Adolescents and Adults – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm

  Specific microbiologic diagnosis of N. gonorrhoeae infection should be performed for all persons at risk for or suspected of having gonorrhea; a specific diagnosis can potentially reduce complications, reinfections, and transmission. […] Culture, NAAT, and POC NAAT, such as GeneXpert (Cepheid), are available for detecting genitourinary infection with N. gonorrhoeae; culture requires endocervical (women) or urethral (men) swab specimens. […] NAAT sensitivity for detecting N. gonorrhoeae from urogenital and nongenital anatomic sites is superior to culture but varies by NAAT type. […] In cases of suspected or documented treatment failure, clinicians should perform both culture and antimicrobial susceptibility testing because NAATs cannot provide antimicrobial susceptibility results. […] Because of its high specificity (99%) and sensitivity (95%), a Gram stain of urethral discharge or secretions that demonstrate polymorphonuclear leukocytes with intracellular gram-negative diplococci can be considered diagnostic for infection with N. gonorrhoeae among symptomatic men. […] Infection detection by using Gram stain of endocervical, pharyngeal, and rectal specimens also is insensitive and is not recommended. […] Gonococcal infection is diagnosed among symptomatic men by documenting the presence of a WBC-containing intracellular purple diplococci in MB or GV smears.

• #34

  https://www.who.int/news-room/fact-sheets/detail/gonorrhoea-(neisseria-gonorrhoeae-infection)

  Molecular tests are the gold standard for diagnosing N. gonorrhoeae which can be performed in the laboratory or at the point of care. […] Rapid diagnostic tests are currently under development. […] Gram stain microscopy is used in some laboratories. However, this method is less sensitive in women with vaginal/cervical discharge as well as for throat and anal infections. […] In many primary health care settings where diagnostic capacity for detecting N. gonorrhoeae is not available, a syndromic approach for case management is recommended. […] Sexual history taking and risk assessment are crucial in evaluating a service user before diagnosis. Clinical examination, speculum examination (in women) and palpation can provide important clues to clinical diagnosis. […] Urine samples (preferred for men) are commonly used for diagnosing gonorrhoea, but swabs (preferred for women) from genital and other sites (anus, throat, conjunctiva) can be used depending on the location of symptoms, sexual practices and medical history.

• #35 New Unitaid report calls for more effective, affordable gonorrhea diagnostics to address rising infections and antimicrobial resistance – Unitaid

  https://unitaid.org/news-blog/new-unitaid-report-calls-for-more-effective-affordable-gonorrhea-diagnostics-to-address-rising-infections-and-antimicrobial-resistance/

  Over 82 million gonorrhea cases occur annually, disproportionately affecting low- and middle-income countries. Drug-resistant strains threaten to render treatments ineffective, increasing the urgency for improved diagnostics and treatment options. […] The report examines access gaps for tools that support sexual and reproductive health, calling for a concerted effort to address market gaps and incentivize the development and introduction of affordable, rapid point-of-care diagnostics for gonorrhea in response to rising infections and antimicrobial resistance. […] Recent advancements in point-of-care diagnostic technologies, including molecular tests, offer improved accuracy and same-day treatment, crucial for controlling gonorrhea and limiting drug resistance, but high costs and limited infrastructure in low- and middle-income countries prevent access.

• #36 A New Diagnostic Tool for Gonorrhea?logo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na57141/2024/02/23/new-diagnostic-tool-gonorrhea

  A New Diagnostic Tool for Gonorrhea? […] In preliminary studies, a novel point-of-care assay for detecting Neisseria gonorrhoeae accurately identified the infection in 96.5% of symptomatic men and 95.5% of symptomatic women. […] To assess the performance of a lateral flow (LF) assay that provides a result from a urine sample (in men) and a vaginal swab sample (in women) within 30 minutes, investigators tested 200 men presenting with urethral discharge and 200 women with vaginal discharge at primary care clinics in South Africa. […] Among men, sensitivity of the LF assay was 96% and specificity was 97%. Among women, sensitivity was 92% and specificity 96%. […] The developers of this test were aiming for sensitivity >80% and specificity >95%, both of which were achieved in this population. […] Further studies must be conducted among persons without overt symptoms — this is especially important for women, in whom gonorrhea is likely to be asymptomatic. […] However, this test may provide an important addition to the toolbox for diagnosing STIs in resource-limited settings.

• #37 Gonorrhea Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/sexual-and-reproductive-health/gonorrhea/diagnosis.html

  How is gonorrhea diagnosed? Diagnosis of gonorrhea includes a medical history and a physical exam. Your doctor may ask you the following questions. […] Several tests can be used to confirm an infection. Your doctor will collect a sample of fluid or urine to be tested. Most tests give results in a few days. […] The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommend gonorrhea screening for all sexually active women ages 24 and younger. The CDC and USPSTF also recommend screening for women older than 24 who have risk factors for gonorrhea. […] Testing will allow gonorrhea to be quickly diagnosed and treated. This helps reduce the risk of transmitting gonorrhea. It also helps you avoid complications of the infection. […] The CDC also recommends screening for at-risk pregnant women. This can prevent them from passing gonorrhea to their babies. If a pregnant woman is at high risk for gonorrhea, she may be tested again during her third trimester.

• #38 Gonorrhea Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/gonorrhea-test/

  Gonorrhea is one of the most common sexually transmitted diseases (STDs). It is a bacterial infection. Anyone can get gonorrhea if they have vaginal, oral, or anal sex with someone who has the infection. The bacteria often infect the genitals, but it can infect the rectum, throat, eyes, and other parts of the body. […] A gonorrhea test looks for signs of gonorrhea bacteria in a sample of fluid from your body. The fluid used depends on the type of gonorrhea test and where the infection may be. Samples may include: […] A gonorrhea test can help find the disease early so you can get treatment before you develop lasting health problems or spread it to others. […] A gonorrhea test is used to: […] Diagnose or rule out gonorrhea when you have symptoms. […] If you are sexually active and have symptoms, you need a test to diagnose or rule out gonorrhea. The symptoms of gonorrhea depend on where the infection is. Symptoms include:

• #39 Gonorrhea: Testing and Treatment of the gonococcal Urethritis

  https://www.urology-textbook.com/gonorrhea-treatment.html

  Indications for microbiological testing in men: Urethral discharge, diagnosis of any other STI, sexual partners with STI, and acute epididymitis in a male under 40 years. […] Indications for microbiological testing in women: Vaginal discharge with risk factors for STI (history, age), diagnosis of any other STI, sexual partners of patients with STI, and acute pelvic inflammatory disease. […] The microbiological diagnosis is possible with different techniques: NAAT: With the help of a NAAT (Nucleic Acid Amplification Test), gonococci, chlamydia and mycoplasma are detected with high sensitivity and specificity. […] Microscopic diagnosis: Two microscope slides for Gram stain (gonococcus) and Giemsa stain (Chlamydia) are prepared if a microscopic pathogen detection is sought. […] Culture and antimicrobial susceptibility testing: Culture and antimicrobial susceptibility testing of Neisseria gonorrhoeae is possible with Martin-Lewis plates or Thayer-Martin agar. […] Diagnosis and co-treatment of the sexual partner(s) is very important. […] All symptom-free patients should receive a NAAT TOC two weeks after treatment. If positive for gonococci, culture and resistance testing should be awaited before further antibiotic therapy.

• #40 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Gram stains, cultures, and nucleic acid amplification tests (NAATs) of genital, rectal, conjunctival, pharyngeal secretions and/or other extragenital sites, as applicable, should also be obtained when DGI is suspected. […] The highest yield of N gonorrhoeae organisms in gonococcemia is from mucosal sites, including the pharynx, urethra, cervix, or rectum. […] A negative Gram stain result is not sufficient for excluding neisserial infections in asymptomatic men. […] In women with positive cervical culture results, the Gram stain results from the endocervix are 50-60% sensitive and 82-97% specific. […] The preferred method to screen for genitourinary gonorrhea is collection of vaginal swab specimens sent for NAAT assay testing. […] If the patient needs a concurrent pelvic examination, an endocervical swab is reasonable; however, in contrast with workup in males, first catch urine specimens to detect gonorrhea may detect about 10% fewer infections when compared with vaginal and endocervical swab specimens. […] Extragenital gonorrheal infections (pharyngeal and rectal infections) are often asymptomatic and are not uncommon in certain populations, such as men who have sex with men (MSM).

• #41 Core Concepts – Gonococcal Infections – Self-Study Lessons – National STD Curriculum

  https://www.std.uw.edu/go/comprehensive-study/gonococcal-infections/core-concept/all

  In cases of suspected sexual abuse or assault, the legal standard is to obtain culture samples combined with additional tests in an attempt to identify STIs, including N. gonorrhoeae. […] Routine screening for gonococcal infection in persons at increased risk is recommended in order to decrease morbidity and reduce the burden of disease in the community. […] The following summarizes gonococcal treatment recommendations in the 2021 STI Treatment Guidelines. […] For persons with uncomplicated gonococcal infections of the cervix, urethra, or rectum, the recommended treatment for persons who weigh less than 150 kg is a single intramuscular dose of ceftriaxone 500 mg; for persons who weigh 150 kg or more, the ceftriaxone dose should be increased to 1 gram. […] The following summarizes treatment of disseminated gonococcal infection, including with arthritis and/or dermatitis complications, consists of initial antimicrobial therapy with intramuscular or intravenous ceftriaxone 1 gram every 24 hours.

• #42 Diagnosis and Management of Gonococcal Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1115/p931.html

  Gonococcal infection should prompt physicians to test for other sexually transmitted infections, including human immunodeficiency virus. Because of high reinfection rates, patients should be retested in three to six months. The U.S. Preventive Services Task Force recommends screening for gonorrhea in all sexually active women at increased risk of infection. […] The CDC recommends that all men who have sex with men and practice insertive anal intercourse be screened at least annually for urethral gonococcal infection with a urine nucleic acid amplification test. […] The CDC recommends that all men who have sex with men and practice receptive anal or oral intercourse be screened at least annually for rectal or pharyngeal gonococcal infection with a rectal or pharyngeal nucleic acid amplification swab test.

• #43 Gonorrhea: Testing and Treatment of the gonococcal Urethritis

  https://www.urology-textbook.com/gonorrhea-treatment.html

  Indications for microbiological testing in men: Urethral discharge, diagnosis of any other STI, sexual partners with STI, and acute epididymitis in a male under 40 years. […] Indications for microbiological testing in women: Vaginal discharge with risk factors for STI (history, age), diagnosis of any other STI, sexual partners of patients with STI, and acute pelvic inflammatory disease. […] The microbiological diagnosis is possible with different techniques: NAAT: With the help of a NAAT (Nucleic Acid Amplification Test), gonococci, chlamydia and mycoplasma are detected with high sensitivity and specificity. […] Microscopic diagnosis: Two microscope slides for Gram stain (gonococcus) and Giemsa stain (Chlamydia) are prepared if a microscopic pathogen detection is sought. […] Culture and antimicrobial susceptibility testing: Culture and antimicrobial susceptibility testing of Neisseria gonorrhoeae is possible with Martin-Lewis plates or Thayer-Martin agar. […] Diagnosis and co-treatment of the sexual partner(s) is very important. […] All symptom-free patients should receive a NAAT TOC two weeks after treatment. If positive for gonococci, culture and resistance testing should be awaited before further antibiotic therapy.

• #44 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Gram stains, cultures, and nucleic acid amplification tests (NAATs) of genital, rectal, conjunctival, pharyngeal secretions and/or other extragenital sites, as applicable, should also be obtained when DGI is suspected. […] The highest yield of N gonorrhoeae organisms in gonococcemia is from mucosal sites, including the pharynx, urethra, cervix, or rectum. […] A negative Gram stain result is not sufficient for excluding neisserial infections in asymptomatic men. […] In women with positive cervical culture results, the Gram stain results from the endocervix are 50-60% sensitive and 82-97% specific. […] The preferred method to screen for genitourinary gonorrhea is collection of vaginal swab specimens sent for NAAT assay testing. […] If the patient needs a concurrent pelvic examination, an endocervical swab is reasonable; however, in contrast with workup in males, first catch urine specimens to detect gonorrhea may detect about 10% fewer infections when compared with vaginal and endocervical swab specimens. […] Extragenital gonorrheal infections (pharyngeal and rectal infections) are often asymptomatic and are not uncommon in certain populations, such as men who have sex with men (MSM).

• #45 Gonorrhea Causes and Diagnoses | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/infectious-disease/gonorrhea/causes-and-diagnoses

  Diagnosing gonorrhea may begin with a physical exam (including a pelvic exam for women) and a discussion of your symptoms. Tests may include: […] A urine sample is stored in an environment that encourages bacterial growth to help identify what the infectious agent is. […] Depending on your symptoms, a swab of fluid from your cervix, rectum, throat or eyes may be taken for study. […] Your sample may be checked for the chlamydia infection at the same time.

• #46 Gonorrhea – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/sexually-transmitted-infections-stis/gonorrhea

  In the US, confirmed cases of gonorrhea, chlamydial infection, and syphilis must be reported to the public health system. […] A cervical swab should be sent for culture or NAAT. If a pelvic examination is not possible, NAAT of a urine sample or self-collected vaginal swab can detect gonococcal (and chlamydial) infections rapidly and reliably. […] Swabs of the affected area are sent for culture or NAAT. […] An affected joint should be aspirated, and fluid should be sent for culture and routine analysis. […] Patients with skin lesions, systemic symptoms, or both should have blood, urethral, cervical, and rectal cultures or NAAT. […] Gonorrhea is diagnosed when gonococci are detected via microscopic examination using a nucleic acid-based test, Gram stain, or culture of genital fluids, blood, or joint fluids (obtained by needle aspiration).

• #47 Gonorrhea Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/sexual-and-reproductive-health/gonorrhea/diagnosis.html

  How is gonorrhea diagnosed? Diagnosis of gonorrhea includes a medical history and a physical exam. Your doctor may ask you the following questions. […] Several tests can be used to confirm an infection. Your doctor will collect a sample of fluid or urine to be tested. Most tests give results in a few days. […] The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommend gonorrhea screening for all sexually active women ages 24 and younger. The CDC and USPSTF also recommend screening for women older than 24 who have risk factors for gonorrhea. […] Testing will allow gonorrhea to be quickly diagnosed and treated. This helps reduce the risk of transmitting gonorrhea. It also helps you avoid complications of the infection. […] The CDC also recommends screening for at-risk pregnant women. This can prevent them from passing gonorrhea to their babies. If a pregnant woman is at high risk for gonorrhea, she may be tested again during her third trimester.

• #48 Recommendations For the Diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis, Including Extra-Genital Sites

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3763711/

  Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the two most common reportable sexually transmitted infections (STIs) in the United States. Clinicians should be aware of current screening recommendations and diagnostic methods for detection of gonorrhea and chlamydia in genital as well as extra-genital sites to address this prevailing epidemic, particularly among younger women and MSM. […] The current standard laboratory test for detection of urogenital chlamydia and gonorrhea is a nucleic acid amplification test (NAAT). These tests are extremely sensitive and specific for detection of both organisms (90%) using a noninvasive urine sample, thus reducing the need for pelvic examination or urethral sampling. Current guidelines recommend screening all women age 25 years or younger for chlamydia and gonorrhea, as well as women older than 25 who have a history of STIs, new or multiple sex partners, or exchange sex for drugs or money.

• #49 Diagnosis and Management of Gonococcal Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1115/p931.html

  Gonococcal infection should prompt physicians to test for other sexually transmitted infections, including human immunodeficiency virus. Because of high reinfection rates, patients should be retested in three to six months. The U.S. Preventive Services Task Force recommends screening for gonorrhea in all sexually active women at increased risk of infection. […] The CDC recommends that all men who have sex with men and practice insertive anal intercourse be screened at least annually for urethral gonococcal infection with a urine nucleic acid amplification test. […] The CDC recommends that all men who have sex with men and practice receptive anal or oral intercourse be screened at least annually for rectal or pharyngeal gonococcal infection with a rectal or pharyngeal nucleic acid amplification swab test.

• #50 Gonorrhea: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/4217-gonorrhea

  Yes. Prompt treatment can cure gonorrhea. Take all medicine as your healthcare provider instructs, even if your symptoms improve and you start to feel better. […] Taking all antibiotics as prescribed is always important, but its especially important with gonorrhea. Gonorrhea is curable now, but its becoming more resistant to antibiotics. Some forms of gonorrhea that have developed a high level of antibiotic resistance are commonly referred to as super gonorrhea. […] The only way to prevent gonorrhea is not to have sex. For many people, a more realistic goal is to reduce the risk of contracting and spreading gonorrhea. […] The Centers for Disease Control and Prevention (CDC) recommends that all women who are sexually active and under 25 get tested for gonorrhea each year. […] People who get prompt treatment and follow treatment instructions can resume their normal lives within one to two weeks. Untreated gonorrhea can cause several long-term health problems.

• #51 Gonorrhea: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/007267.htm

  If you have gonorrhea, you should ask to be tested for other sexually transmitted infections, including chlamydia, syphilis, HIV, herpes, and hepatitis. […] Screening for gonorrhea in asymptomatic people should take place in the following groups: Sexually active females 24 years and younger; Women older than 24 years who are at increased risk for infection. […] It is unclear whether screening men for gonorrhea is beneficial.

• #52 Chlamydia, Gonorrhea, and Syphilis | ACOG

  https://www.acog.org/womens-health/faqs/chlamydia-gonorrhea-and-syphilis

  Gonorrhea is the second most common STI in the United States. Gonorrhea is caused by bacteria that pass to a partner during vaginal, anal, or oral sex. […] It is common to be infected with both gonorrhea and chlamydia at the same time. […] Gonorrhea tests can be done on a urine sample or on samples taken with a swab from the vagina, mouth, throat, rectum, or the area around the cervix. You can do a self-swab of your vagina or rectum in the office of your ob-gyn or other health care professional. You may also be able to self-test at home. […] A yearly screening test is recommended if you are younger than 25 or if you are 25 and older and have risk factors for gonorrhea. […] Gonorrhea is treated with two kinds of antibiotics. The recommended treatment is an injection of one antibiotic followed by a single pill of another antibiotic. If the injection is not available, you can take two types of antibiotic pills. This treatment is also effective against chlamydia.

• #53 Chlamydial and Gonococcal Infections: Screening, Diagnosis, and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0400/p388.html

  Infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae are increasing in the United States. Because most infections are asymptomatic, screening is key to preventing complications such as pelvic inflammatory disease and infertility and decreasing community and vertical neonatal transmission. All sexually active people with a cervix who are younger than 25 years and older people with a cervix who have risk factors should be screened annually for chlamydial and gonococcal infections. Sexually active men who have sex with men should be screened at least annually. […] The CDC recommends using nucleic acid amplification testing (NAAT) for the diagnosis of gonococcal or chlamydial infections because it is the most sensitive. Specimens can be taken from a first-stream urine sample without urethral cleansing before collection. Clinician- or patient-collected vaginal or endocervical swabs are also acceptable specimens. Self-collected vaginal swabs are as sensitive as clinician-collected swabs and are preferred by patients.

• #54 Core Concepts – Gonococcal Infections – Self-Study Lessons – National STD Curriculum

  https://www.std.uw.edu/go/comprehensive-study/gonococcal-infections/core-concept/all

  Gonorrhea is the second most common notifiable sexually transmitted infection (STI) in the United States. This infection is caused by the gram-negative bacterium Neisseria gonorrhoeae and is transmitted through sexual activity or perinatally during vaginal delivery. In the modern era, there are excellent diagnostic tests for gonorrhea. […] The approach to diagnostic testing for N. gonorrhoeae has evolved from traditional cultivation to the widespread use of nucleic acid amplification tests (NAATs. […] The NAATs used for detecting N. gonorrhoeae in the United States include polymerase chain reaction tests (Roche Amplicor and Cepheid GeneXpert CT/NG), transcription-mediated amplification (Gen-Probe Aptima), and strand displacement amplification (Becton-Dickinson BDProbeTec ET). […] A Gram stain is inadequate for evaluating prepubertal children for gonorrhea and should not be used to diagnose or exclude gonorrhea.

• #55 Core Concepts – Gonococcal Infections – Self-Study Lessons – National STD Curriculum

  https://www.std.uw.edu/go/comprehensive-study/gonococcal-infections/core-concept/all

  In cases of suspected sexual abuse or assault, the legal standard is to obtain culture samples combined with additional tests in an attempt to identify STIs, including N. gonorrhoeae. […] Routine screening for gonococcal infection in persons at increased risk is recommended in order to decrease morbidity and reduce the burden of disease in the community. […] The following summarizes gonococcal treatment recommendations in the 2021 STI Treatment Guidelines. […] For persons with uncomplicated gonococcal infections of the cervix, urethra, or rectum, the recommended treatment for persons who weigh less than 150 kg is a single intramuscular dose of ceftriaxone 500 mg; for persons who weigh 150 kg or more, the ceftriaxone dose should be increased to 1 gram. […] The following summarizes treatment of disseminated gonococcal infection, including with arthritis and/or dermatitis complications, consists of initial antimicrobial therapy with intramuscular or intravenous ceftriaxone 1 gram every 24 hours.

• #56 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Gram stains, cultures, and nucleic acid amplification tests (NAATs) of genital, rectal, conjunctival, pharyngeal secretions and/or other extragenital sites, as applicable, should also be obtained when DGI is suspected. […] The highest yield of N gonorrhoeae organisms in gonococcemia is from mucosal sites, including the pharynx, urethra, cervix, or rectum. […] A negative Gram stain result is not sufficient for excluding neisserial infections in asymptomatic men. […] In women with positive cervical culture results, the Gram stain results from the endocervix are 50-60% sensitive and 82-97% specific. […] The preferred method to screen for genitourinary gonorrhea is collection of vaginal swab specimens sent for NAAT assay testing. […] If the patient needs a concurrent pelvic examination, an endocervical swab is reasonable; however, in contrast with workup in males, first catch urine specimens to detect gonorrhea may detect about 10% fewer infections when compared with vaginal and endocervical swab specimens. […] Extragenital gonorrheal infections (pharyngeal and rectal infections) are often asymptomatic and are not uncommon in certain populations, such as men who have sex with men (MSM).

• #57 Systemic Gonococcal Infection: Causes, Symptoms & Diagnosis

  https://www.healthline.com/health/gonococcemia-disseminated

  Gonorrhea is a sexually transmitted infection (STI) caused by the bacteria Neisseria gonorrhoeae. […] Your doctor will check to see whether you have gonorrhea or symptoms of DGI. […] To test for gonorrhea, your doctor will take a sample or culture from the affected area. They will then send the sample to a lab where its analyzed for the presence of gonorrhea bacteria. Results are often available within 24 hours. […] If your test results come back positive for gonorrhea, your doctor may order additional tests to determine whether you have other STIs. Gonorrhea is often diagnosed alongside other STIs, such as chlamydia. […] Untreated gonorrhea can spread and enter the bloodstream, and cause serious complications, such as DGI. […] Antibiotics treat gonorrhea and DGI. […] Treatment for uncomplicated gonorrhea usually involves the use of a single dose of two antibiotics, one by mouth (azithromycin) and one by injection (ceftriaxone).

• #58 Gonorrhea – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/sexually-transmitted-infections-stis/gonorrhea

  In the US, confirmed cases of gonorrhea, chlamydial infection, and syphilis must be reported to the public health system. […] A cervical swab should be sent for culture or NAAT. If a pelvic examination is not possible, NAAT of a urine sample or self-collected vaginal swab can detect gonococcal (and chlamydial) infections rapidly and reliably. […] Swabs of the affected area are sent for culture or NAAT. […] An affected joint should be aspirated, and fluid should be sent for culture and routine analysis. […] Patients with skin lesions, systemic symptoms, or both should have blood, urethral, cervical, and rectal cultures or NAAT. […] Gonorrhea is diagnosed when gonococci are detected via microscopic examination using a nucleic acid-based test, Gram stain, or culture of genital fluids, blood, or joint fluids (obtained by needle aspiration).

• #59 Gonorrhea Differential Diagnoses

  https://emedicine.medscape.com/article/218059-differential

  When evaluating a female patient with suspected gonococcal infection, also consider bacterial vaginosis, vaginitis, ectopic pregnancy, pregnancy, tubo-ovarian abscess, endometriosis, and mucopurulent cervicitis. In men, consider epididymitis, orchitis, and testicular torsion. […] Other conditions that should be considered include the following: Urinary tract infections, Pharyngitis; hepatitis, Herpes simplex urethritis, Rat-bite fever, Inflammatory and septic arthritis, Nongonococcal conjunctivitis, endocarditis, meningitis, and urethritis. […] Other causes of arthritis and dermatitis may display a clinical picture similar to that of disseminated gonococcal infection (DGI), with some notable differences. […] Certain risk factors for disseminated infection should be kept in mind, such as acquired complement deficiencies (C5, C6, C7, C8), underlying systemic lupus erythematosus, pregnancy, and recent menstruation.

• #60 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Perform a culture or nonculture detection test for N gonorrhoeae on endocervical, urethral, pharyngeal, or rectal discharge. […] Nonculture tests are less accurate in the presence of blood or during menses. Use culture instead at these times. […] Culture is performed on Thayer-Martin plates that must be stored refrigerated but warmed to room temperature before obtaining a sample. […] Medicolegal cases (eg, child abuse, rape) require culture due to the possibility of false-positive results with nonculture methods. […] Patients with gonococcemia may have an elevated white blood cell (WBC) count, in the range of 10,000-15,000/L. […] The erythrocyte sedimentation rate (ESR) is usually mildly elevated, with values from 20-50 in most patients. […] These tests include latex agglutination, ELISA, immunoprecipitation, and complement fixation tests.

• #61 Core Concepts – Gonococcal Infections – Self-Study Lessons – National STD Curriculum

  https://www.std.uw.edu/go/comprehensive-study/gonococcal-infections/core-concept/all

  In cases of suspected sexual abuse or assault, the legal standard is to obtain culture samples combined with additional tests in an attempt to identify STIs, including N. gonorrhoeae. […] Routine screening for gonococcal infection in persons at increased risk is recommended in order to decrease morbidity and reduce the burden of disease in the community. […] The following summarizes gonococcal treatment recommendations in the 2021 STI Treatment Guidelines. […] For persons with uncomplicated gonococcal infections of the cervix, urethra, or rectum, the recommended treatment for persons who weigh less than 150 kg is a single intramuscular dose of ceftriaxone 500 mg; for persons who weigh 150 kg or more, the ceftriaxone dose should be increased to 1 gram. […] The following summarizes treatment of disseminated gonococcal infection, including with arthritis and/or dermatitis complications, consists of initial antimicrobial therapy with intramuscular or intravenous ceftriaxone 1 gram every 24 hours.

• #62 Core Concepts – Gonococcal Infections – Self-Study Lessons – National STD Curriculum

  https://www.std.uw.edu/go/comprehensive-study/gonococcal-infections/core-concept/all

  Gonorrhea is the second most common notifiable sexually transmitted infection (STI) in the United States. This infection is caused by the gram-negative bacterium Neisseria gonorrhoeae and is transmitted through sexual activity or perinatally during vaginal delivery. In the modern era, there are excellent diagnostic tests for gonorrhea. […] The approach to diagnostic testing for N. gonorrhoeae has evolved from traditional cultivation to the widespread use of nucleic acid amplification tests (NAATs. […] The NAATs used for detecting N. gonorrhoeae in the United States include polymerase chain reaction tests (Roche Amplicor and Cepheid GeneXpert CT/NG), transcription-mediated amplification (Gen-Probe Aptima), and strand displacement amplification (Becton-Dickinson BDProbeTec ET). […] A Gram stain is inadequate for evaluating prepubertal children for gonorrhea and should not be used to diagnose or exclude gonorrhea.

• #63 Gonorrhea Test – Testing.com

  https://www.testing.com/tests/gonorrhea-test/

  Gonorrhea testing is performed on a urine sample or a swab from the site of potential infection, often the urethra, cervix, mouth, or rectum. […] Results of gonorrhea testing may be reported during a follow-up appointment with your doctor, over the phone, or through online medical charts. […] If test results are positive for gonorrhea, begin treatment as early as possible to reduce the risk of health complications and prevent spreading the infection to others. […] Gonorrhea test results are reported as positive or negative. A positive result, sometimes called an abnormal result, indicates that you have an active gonorrhea infection that requires treatment.

• #64 Gonorrhea Test: What It Is, Purpose, Procedure & Results

  https://my.clevelandclinic.org/health/diagnostics/25211-gonorrhea-test

  Your gonorrhea test results will either be negative (not detected) or positive (detected): A negative (not detected) result means your sample didnt contain the Neisseria gonorrhoeae bacterium. […] A positive (detected) result means you have gonorrhea. If you test positive, youll need to start antibiotic treatment right away and inform your sex partners so they can get treatment, too. […] Currently, theres no blood test that can detect gonorrhea. Youll need to provide a urine or swab sample for a proper diagnosis. […] Taking a gonorrhea test is the only way to know for sure if you have an infection.

• #65 Gonorrhea Test: What It Is, Purpose, Procedure & Results

  https://my.clevelandclinic.org/health/diagnostics/25211-gonorrhea-test

  Your gonorrhea test results will either be negative (not detected) or positive (detected): A negative (not detected) result means your sample didnt contain the Neisseria gonorrhoeae bacterium. […] A positive (detected) result means you have gonorrhea. If you test positive, youll need to start antibiotic treatment right away and inform your sex partners so they can get treatment, too. […] Currently, theres no blood test that can detect gonorrhea. Youll need to provide a urine or swab sample for a proper diagnosis. […] Taking a gonorrhea test is the only way to know for sure if you have an infection.

• #66 Gonorrhea Test – Testing.com

  https://www.testing.com/tests/gonorrhea-test/

  Gonorrhea testing is performed on a urine sample or a swab from the site of potential infection, often the urethra, cervix, mouth, or rectum. […] Results of gonorrhea testing may be reported during a follow-up appointment with your doctor, over the phone, or through online medical charts. […] If test results are positive for gonorrhea, begin treatment as early as possible to reduce the risk of health complications and prevent spreading the infection to others. […] Gonorrhea test results are reported as positive or negative. A positive result, sometimes called an abnormal result, indicates that you have an active gonorrhea infection that requires treatment.

• #67 Patient education: Gonorrhea (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/gonorrhea-beyond-the-basics/print

  GONORRHEA DIAGNOSIS […] Testing for gonorrhea is usually done in a doctor or nurse’s office or clinic. Tests that can be self-collected at home and sent to a laboratory for testing are increasingly available, but not all of them are accurate. […] Tests can be performed on a urine sample, a swab of the vagina or cervix (in females), or a swab of the urethra (in males). Testing for oral or rectal gonorrhea can also be performed with a swab. Most clinics may provide results within one to three days, depending on the type of test performed. Some clinics use tests that can provide immediate results. […] People who do a home test and receive a positive or indeterminate result should see a health care provider promptly. Even if the test is negative, they should still see a health care provider if they have symptoms or may have been exposed.

• #68 The laboratory diagnosis of Neisseria gonorrhoeae

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095009/

  The presumptive identification of N gonorrhoeae rests on the isolation of an oxidase-positive, Gram-negative diplococcus recovered from urogenital sites that grows on selective media. […] Several methods are available to confirm the identification of N gonorrhoeae, including biochemical testing, serological testing, colourimetric testing and nucleic acid methods. More than one system may be required to confirm identification. […] Molecular detection methods allow for a more rapid and specific diagnosis of pathogens that are fastidious or cannot be cultured. Nucleic acid methods developed for sexually transmitted pathogens are rapid, highly sensitive and specific for the detection of these organisms in clinical specimens. […] The nucleic acid tests, especially the semi-automated and automated systems, are less labour intensive than cultural methods and allow high throughput processing of clinical specimens. The processing time for nucleic acid methods is shorter than for cultural methods. […] Identification of N gonorrhoeae requires confirmation using two different methods involving different principles (or different gene targets in nucleic acid detection methods), especially in medicolegal cases.

• #69 Gonorrhea Differential Diagnoses

  https://emedicine.medscape.com/article/218059-differential

  When evaluating a female patient with suspected gonococcal infection, also consider bacterial vaginosis, vaginitis, ectopic pregnancy, pregnancy, tubo-ovarian abscess, endometriosis, and mucopurulent cervicitis. In men, consider epididymitis, orchitis, and testicular torsion. […] Other conditions that should be considered include the following: Urinary tract infections, Pharyngitis; hepatitis, Herpes simplex urethritis, Rat-bite fever, Inflammatory and septic arthritis, Nongonococcal conjunctivitis, endocarditis, meningitis, and urethritis. […] Other causes of arthritis and dermatitis may display a clinical picture similar to that of disseminated gonococcal infection (DGI), with some notable differences. […] Certain risk factors for disseminated infection should be kept in mind, such as acquired complement deficiencies (C5, C6, C7, C8), underlying systemic lupus erythematosus, pregnancy, and recent menstruation.

• #70 Gonorrhea differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Gonorrhea_differential_diagnosis

  Gonorrhea must be differentiated from other sexually transmitted pathogens, nongonococcal urethritis, vaginitis, cervicitis, urinary tract infections, prostatitis, and orchitis. Additionally, disseminated gonococcal infection must be differentiated from herpes simplex virus (HSV), nongonococcal septic arthritis, syphilis, HIV infection, rheumatic fever, reactive arthritis, and Lyme disease. […] Gonorrhea must be differentiated from other sexually transmitted pathogens including Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium, herpes simplex virus (HSV), and syphilis. Conditions that must be considered in the differential diagnosis of gonorrhea include: […] Disseminated gonococcal infection must be differentiated from: […] Viral culture, polymerase chain reaction (PCR), and direct fluorescence antibody confirm the presence of the causative agent.

• #71 Gonorrhea Differential Diagnoses

  https://emedicine.medscape.com/article/218059-differential

  When evaluating a female patient with suspected gonococcal infection, also consider bacterial vaginosis, vaginitis, ectopic pregnancy, pregnancy, tubo-ovarian abscess, endometriosis, and mucopurulent cervicitis. In men, consider epididymitis, orchitis, and testicular torsion. […] Other conditions that should be considered include the following: Urinary tract infections, Pharyngitis; hepatitis, Herpes simplex urethritis, Rat-bite fever, Inflammatory and septic arthritis, Nongonococcal conjunctivitis, endocarditis, meningitis, and urethritis. […] Other causes of arthritis and dermatitis may display a clinical picture similar to that of disseminated gonococcal infection (DGI), with some notable differences. […] Certain risk factors for disseminated infection should be kept in mind, such as acquired complement deficiencies (C5, C6, C7, C8), underlying systemic lupus erythematosus, pregnancy, and recent menstruation.

• #72 Gonorrhea Differential Diagnoses

  https://emedicine.medscape.com/article/218059-differential

  When evaluating a female patient with suspected gonococcal infection, also consider bacterial vaginosis, vaginitis, ectopic pregnancy, pregnancy, tubo-ovarian abscess, endometriosis, and mucopurulent cervicitis. In men, consider epididymitis, orchitis, and testicular torsion. […] Other conditions that should be considered include the following: Urinary tract infections, Pharyngitis; hepatitis, Herpes simplex urethritis, Rat-bite fever, Inflammatory and septic arthritis, Nongonococcal conjunctivitis, endocarditis, meningitis, and urethritis. […] Other causes of arthritis and dermatitis may display a clinical picture similar to that of disseminated gonococcal infection (DGI), with some notable differences. […] Certain risk factors for disseminated infection should be kept in mind, such as acquired complement deficiencies (C5, C6, C7, C8), underlying systemic lupus erythematosus, pregnancy, and recent menstruation.

• #73 Gonorrhea Differential Diagnoses

  https://emedicine.medscape.com/article/218059-differential

  When evaluating a female patient with suspected gonococcal infection, also consider bacterial vaginosis, vaginitis, ectopic pregnancy, pregnancy, tubo-ovarian abscess, endometriosis, and mucopurulent cervicitis. In men, consider epididymitis, orchitis, and testicular torsion. […] Other conditions that should be considered include the following: Urinary tract infections, Pharyngitis; hepatitis, Herpes simplex urethritis, Rat-bite fever, Inflammatory and septic arthritis, Nongonococcal conjunctivitis, endocarditis, meningitis, and urethritis. […] Other causes of arthritis and dermatitis may display a clinical picture similar to that of disseminated gonococcal infection (DGI), with some notable differences. […] Certain risk factors for disseminated infection should be kept in mind, such as acquired complement deficiencies (C5, C6, C7, C8), underlying systemic lupus erythematosus, pregnancy, and recent menstruation.

• #74 Gonorrhea differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Gonorrhea_differential_diagnosis

  Gonorrhea must be differentiated from other sexually transmitted pathogens, nongonococcal urethritis, vaginitis, cervicitis, urinary tract infections, prostatitis, and orchitis. Additionally, disseminated gonococcal infection must be differentiated from herpes simplex virus (HSV), nongonococcal septic arthritis, syphilis, HIV infection, rheumatic fever, reactive arthritis, and Lyme disease. […] Gonorrhea must be differentiated from other sexually transmitted pathogens including Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium, herpes simplex virus (HSV), and syphilis. Conditions that must be considered in the differential diagnosis of gonorrhea include: […] Disseminated gonococcal infection must be differentiated from: […] Viral culture, polymerase chain reaction (PCR), and direct fluorescence antibody confirm the presence of the causative agent.

• #75 Gonorrhea Differential Diagnoses

  https://emedicine.medscape.com/article/218059-differential

  Reactive arthritis is a human leukocyte antigen B27 (HLA-B27)associated condition that predominantly occurs in young men and has the clinical triad of urethritis, conjunctivitis, and arthritis. […] This syndrome does not respond to antibiotic therapy, and it does not have the associated dermatitis that occurs in gonococcemia. […] Nongonococcal septic arthritis can be caused by a variety of organisms, but it presents with an acute onset of joint swelling and pain. […] Culture of joint fluid commonly reveals organisms. […] This type of arthritis is a destructive form of arthritis that usually is monoarticular. […] Immediate treatment with antibiotics is indicated. […] Syphilis, an STD that commonly occurs in sexually active young adults, also can produce a rash, symptoms of arthritis, and genital lesions.

• #76 Gonorrhea Differential Diagnoses

  https://emedicine.medscape.com/article/218059-differential

  Laboratory tests, including rapid plasma reagin (RPR) titers, can aid in distinguishing syphilis from gonococcemia. […] Other conditions to consider in a patient with arthritis and skin lesions include the following: Meningococcemia, Hepatitis, Bacterial endocarditis, Systemic lupus erythematosus (SLE), Tenosynovitis (eg, de Quervain disease, infectious), Other seronegative arthritides – Eg, ankylosing spondylitis, Sweet syndrome, and related dermal vasculitides. […] Other conditions to consider in the differential diagnosis of N gonorrhoeae infection include the following: Sexual abuse, Enuresis, Sexual assault, Testicular torsion, Trichomoniasis, Endometritis, Vaginitis, Acanthosis nigricans, Cutaneous manifestations of hepatitis C, Lyme disease, Meningococcemia, Psoriatic arthritis, Syphilis.

• #77 Gonorrhea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gonorrhea/diagnosis-treatment/drc-20351780

  You may be able to use a test that’s available without a prescription, sometimes called an at-home test, to see if you have gonorrhea. If that test shows you have gonorrhea, you’ll need to see a healthcare professional to confirm the diagnosis and start treatment. […] To determine whether you have gonorrhea, your healthcare professional will analyze a sample of cells. Samples can be collected with: […] A urine test. This can help identify bacteria in your urethra. […] A swab of the affected area. A swab of your throat, urethra, vagina or rectum can collect bacteria that can be identified in a lab. […] Your healthcare professional may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. […] Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for other sexually transmitted infections could be beneficial as well.

• #78 Gonorrhea: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/007267.htm

  If you have gonorrhea, you should ask to be tested for other sexually transmitted infections, including chlamydia, syphilis, HIV, herpes, and hepatitis. […] Screening for gonorrhea in asymptomatic people should take place in the following groups: Sexually active females 24 years and younger; Women older than 24 years who are at increased risk for infection. […] It is unclear whether screening men for gonorrhea is beneficial.

• #79 Diagnosis and Management of Gonococcal Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1115/p931.html

  Gonococcal infection should prompt physicians to test for other sexually transmitted infections, including human immunodeficiency virus. Because of high reinfection rates, patients should be retested in three to six months. The U.S. Preventive Services Task Force recommends screening for gonorrhea in all sexually active women at increased risk of infection. […] The CDC recommends that all men who have sex with men and practice insertive anal intercourse be screened at least annually for urethral gonococcal infection with a urine nucleic acid amplification test. […] The CDC recommends that all men who have sex with men and practice receptive anal or oral intercourse be screened at least annually for rectal or pharyngeal gonococcal infection with a rectal or pharyngeal nucleic acid amplification swab test.

• #80

  https://dermnetnz.org/topics/gonorrhoea

  How is the diagnosis of gonorrhoea made? The method used to detect gonorrhoea depends on the setting and available resources. […] Microscopy Gram-stain and visualisation of gram-negative diplococci are appropriate in men with urethral discharge (sensitivity 9095%) and are recommended in people with rectal symptoms (see laboratory investigations for bacterial infections). […] Culture involves specimen collection from the appropriate sites (such as endocervical, urethral, rectal, and pharyngeal areas) and then inoculation onto agar plates that are selective for Neisseria gonorrhoea. […] Nucleic acid amplification tests (NAATs) are increasingly available. […] The treatment of uncomplicated gonorrhoea should be started as soon as possible to prevent further complications. The recommended empirical regime for the treatment of Neisseria gonorrhoea is ceftriaxone 500 mg by intramuscular injection plus azithromycin 1 g orally. […] Tests for other STIs should be undertaken In patients with gonorrhoea to exclude co-infections.

• #81 Chlamydial and Gonococcal Infections: Screening, Diagnosis, and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0400/p388.html

  Infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae are increasing in the United States. Because most infections are asymptomatic, screening is key to preventing complications such as pelvic inflammatory disease and infertility and decreasing community and vertical neonatal transmission. All sexually active people with a cervix who are younger than 25 years and older people with a cervix who have risk factors should be screened annually for chlamydial and gonococcal infections. Sexually active men who have sex with men should be screened at least annually. […] The CDC recommends using nucleic acid amplification testing (NAAT) for the diagnosis of gonococcal or chlamydial infections because it is the most sensitive. Specimens can be taken from a first-stream urine sample without urethral cleansing before collection. Clinician- or patient-collected vaginal or endocervical swabs are also acceptable specimens. Self-collected vaginal swabs are as sensitive as clinician-collected swabs and are preferred by patients.

• #82 Gonorrhea Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/gonorrhea-test/

  Gonorrhea is one of the most common sexually transmitted diseases (STDs). It is a bacterial infection. Anyone can get gonorrhea if they have vaginal, oral, or anal sex with someone who has the infection. The bacteria often infect the genitals, but it can infect the rectum, throat, eyes, and other parts of the body. […] A gonorrhea test looks for signs of gonorrhea bacteria in a sample of fluid from your body. The fluid used depends on the type of gonorrhea test and where the infection may be. Samples may include: […] A gonorrhea test can help find the disease early so you can get treatment before you develop lasting health problems or spread it to others. […] A gonorrhea test is used to: […] Diagnose or rule out gonorrhea when you have symptoms. […] If you are sexually active and have symptoms, you need a test to diagnose or rule out gonorrhea. The symptoms of gonorrhea depend on where the infection is. Symptoms include:

• #83 Gonorrhoea

  https://www.nhs.uk/conditions/gonorrhoea/

  Gonorrhoea is a sexually transmitted infection (STI) passed on through unprotected sex (sex without a condom). It’s treated with antibiotics. If it’s not treated, it can cause serious health problems. […] Not everyone gets symptoms of gonorrhoea. So it’s important to get tested if you think you might have it. […] If you do not have symptoms but want a test, you can use a self-test kit for gonorrhoea at home and send it to a lab to be tested. […] If they think you might have gonorrhoea, the doctor or nurse will ask about your symptoms and sexual partners. They may need to check your penis or vagina. […] Gonorrhoea is treated with a single dose of antibiotics, which can be an injection or tablets. […] You’ll need to go back to the GP surgery or sexual health clinic about a week after starting treatment to be tested again to check you no longer have gonorrhoea.

• #84 Gonorrhea: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/4217-gonorrhea

  Gonorrhea is a common sexually transmitted infection (STI) that comes from a bacteria called Neisseria gonorrhoeae (N. gonorrhoeae). […] If you believe you have gonorrhea, dont wait to seek treatment. Untreated gonorrhea can cause long-term health complications. Your healthcare provider will prescribe antibiotics to clear up a gonorrhea infection. […] Only a healthcare provider can tell you for sure if you have gonorrhea. First, theyll ask you questions about your symptoms and sexual history. Then, your provider will collect a sample of your pee or bodily fluid to check it for the bacteria that causes gonorrhea. […] Youll need antibiotics to treat gonorrhea. Your partner(s) will need treatment, too. […] Gonorrhea infection clears up within seven to 14 days after treatment with antibiotics. Some healthcare providers recommend a second gonorrhea test to make sure the infection is completely gone.

• #85 Gonorrhoea | STI Guidelines Australia

  https://sti.guidelines.org.au/sexually-transmissible-infections/gonorrhoea/

  Gonococcal culture has high specificity and allows for antibiotic susceptibility testing but is much less sensitive than NAAT. […] Gonococcal culture samples should always be collected from all infected sites before antibiotics are administered, but treatment should be administered without waiting for culture results. […] Reduced susceptibility to the first-line treatment of intramuscular injection ceftriaxone and azithromycin is emerging in urban Australia. […] Dual antibiotic treatment is recommended to create a pharmacological barrier to the development of more widespread resistance to treatment. […] Test of cure by NAAT should be performed 2 weeks after treatment is completed, especially if no gonococcal culture swab was collected before treatment, or if the culture swab indicated antimicrobial resistance, or if the patient was treated with a non-standard regimen. […] Re-testing at 3 months is recommended to detect re-infection.

• #86 Chlamydia, Gonorrhea, and Syphilis | ACOG

  https://www.acog.org/womens-health/faqs/chlamydia-gonorrhea-and-syphilis

  You should be retested for gonorrhea 3 months after treatment to be sure the infection is gone. If you cannot be retested 3 months after treatment, you should be retested at a health care visit within the next year. […] Untreated infection with gonorrhea can lead to pelvic inflammatory disease (PID). This happens when bacteria move up from the vagina and cervix and into the uterus and fallopian tubes. Symptoms of PID may include chills, fever, and pelvic pain. Some people may not have symptoms until they have had PID for a while. […] Untreated gonorrhea can also lead to disseminated gonococcal infection.

• #87 Gonorrhea guide: Treatment and follow-up – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/gonorrhea/treatment-follow-up.html

  Updated interim recommendation for preferred treatment of uncomplicated NG infections for adults and adolescents 10 years of age or older. Ceftriaxone 500 mg IM as a single dose (monotherapy). […] Treat all cases confirmed by: Positive NAAT or culture results. Gram-negative intracellular diplococci observed on male urethral smears. […] A test of cure (TOC) is recommended for all positive NG sites in all cases. This is particularly important when regimens other than ceftriaxone 500 mg IM are used. […] Repeat screening of people with a gonococcal infection is recommended six months post treatment, because of the risk of reinfection. […] Gonococcal infections are nationally notifiable and reportable by laboratories, physicians and designated health professionals to local public health authorities in all provinces and territories.

• #88 Chlamydial and Gonococcal Infections: Screening, Diagnosis, and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0400/p388.html

  In 2019, the U.S. Food and Drug Administration (FDA) approved the Aptima Combo 2 Assay and Xpert CT/NG, which use NAAT, for extragenital swabs of the throat and rectum. […] The recommended treatment for non-pregnant people is now doxycycline, 100 mg, twice per day for seven days. […] Nonpregnant people should be tested for reinfection approximately three months after treatment or at the first visit in the 12 months after treatment. Follow-up care recommendations are reviewed in Table 6. […] Most treatment failures are caused by reinfection from sex partners who have not received adequate treatment, rather than treatment failure from antimicrobial resistance. If symptoms do not resolve or a test is persistently positive in a situation in which reinfection seems unlikely, an infectious disease specialist and local health department should be consulted in case of possible antimicrobial resistance.

• #89 Gonorrhea guide: Treatment and follow-up – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/gonorrhea/treatment-follow-up.html

  Treatment and follow-up guidance for Neisseria gonorrhoeae infections. The following information on the preferred treatment for uncomplicated gonorrhea in adults and adolescents consist of an interim guidance from the National Advisory Committee on Sexually Transmitted and Blood-Borne Infections. Alternative treatment options are also currently under review by the NAC-STBBI. Final recommendations will be available after the completion of the review currently underway. […] Over time, treatment of gonorrhea has been complicated by the ability of Neisseria gonorrhoea (NG) to develop antimicrobial resistance (AMR). Optimal treatment is important to prevent long-term complications, decrease transmission, and slow the emergence and spread of AMR. […] AMR in gonorrhea in Canada is monitored by the Gonococcal Antimicrobial Surveillance Program in Canada (GASP-Canada) and the Enhanced Surveillance for Antimicrobial-resistant Gonorrhea (ESAG) system.

• #90 The Laboratory Diagnosis of Neisseria gonorrhoeae: Current Testing and Future Demands

  https://www.mdpi.com/2076-0817/9/2/91

  NAATs are the most sensitive techniques to detect Ng. Sensitivity and specificity of Ng NAATs is generally >95% and >99% in swabs and male first-catch urine. […] Although sensitivity of NAATs is superior to other detection methods, it should be considered that diagnostic accuracy may be affected by genetic variations and the genomic plasticity of Neisseria. […] Positive NAAT results obtained with extragenital specimens should be confirmed by detection of an alternative target to exclude false positive results due to cross reactivity with commensal Neisseria. […] The emergence of AMR strongly impairs the efficacy of Ng treatment and represents a significant clinical and public health challenge. Thus, bacterial culture should be attempted whenever possible. […] Molecular alterations causing resistance to antimicrobials used to treat Ng were well characterized, and a number of real-time PCR tests detecting resistance determinants have been published in the last years.

• #91 Gonococcal Infections Among Adolescents and Adults – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm

  Specific microbiologic diagnosis of N. gonorrhoeae infection should be performed for all persons at risk for or suspected of having gonorrhea; a specific diagnosis can potentially reduce complications, reinfections, and transmission. […] Culture, NAAT, and POC NAAT, such as GeneXpert (Cepheid), are available for detecting genitourinary infection with N. gonorrhoeae; culture requires endocervical (women) or urethral (men) swab specimens. […] NAAT sensitivity for detecting N. gonorrhoeae from urogenital and nongenital anatomic sites is superior to culture but varies by NAAT type. […] In cases of suspected or documented treatment failure, clinicians should perform both culture and antimicrobial susceptibility testing because NAATs cannot provide antimicrobial susceptibility results. […] Because of its high specificity (99%) and sensitivity (95%), a Gram stain of urethral discharge or secretions that demonstrate polymorphonuclear leukocytes with intracellular gram-negative diplococci can be considered diagnostic for infection with N. gonorrhoeae among symptomatic men. […] Infection detection by using Gram stain of endocervical, pharyngeal, and rectal specimens also is insensitive and is not recommended. […] Gonococcal infection is diagnosed among symptomatic men by documenting the presence of a WBC-containing intracellular purple diplococci in MB or GV smears.

• #92 Gonorrhea – Symptoms, Causes, Diagnosis & Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/gonorrhea

  The doctor will obtain a vaginal or cervical swab in women or a urine sample in men for gram stain to search for the Neisseria gonorrhoeae bacteria, culture, or nucleic acid amplification tests (NAAT) to help make the diagnosis. […] If symptoms continue, seek immediate medical care because the bacteria could be an antibiotic-resistant strain.

• #93 Gonorrhea: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/gonorrhea/?srsltid=AfmBOopDv_z0Rk23lJP8QW55Zm1m_myEOlO65_l4X1EU1qbfPZBnTL9_

  Gonorrhea is transmitted through unprotected vaginal, anal, and oral sex. […] Diagnostic tests include (CDC, 2021c): Culture: Endocervical, urethral, oropharyngeal, conjunctival, and rectal specimens can be collected […] Nucleic acid amplification testing (NAAT) and point of care (POC) NAAT: Urine and endocervical, vaginal, urethral, rectal, and pharyngeal swab specimens […] It is important to note that some gonorrhea infections are resistant to antibiotic treatments. […] If symptoms persist and a retest is still positive for gonorrhea, the individual should be tested for antimicrobial-resistant N. gonorrhoeae. […] During the primary and recurrent episodes/outbreaks the individual is at risk of the following nursing diagnoses: Risk for acute pain, Risk of infection, Risk of deficient knowledge of disease and disease processes, Risk for infection transmission, Risk for disruption of the symbiotic maternal-fetal dyad.

• #94

  https://www.who.int/news-room/fact-sheets/detail/gonorrhoea-(neisseria-gonorrhoeae-infection)

  Because majority of cases are without symptoms, screening strategies for populations at increased risk of gonorrhoea to prevent the spread of infection and the development of complications is recommended. Testing is usually coupled with tests for other sexually transmitted infections (such as HIV, syphilis and chlamydia). […] Antimicrobial sensitivity testing for N. gonorrhoeae is done in cases of clinical treatment failure to check if the pathogen is resistant to medications. WHO recommends that countries monitor their patterns of antimicrobial resistance to inform treatment recommendations.

• #95 Gonorrhea guide: Treatment and follow-up – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/gonorrhea/treatment-follow-up.html

  Treatment and follow-up guidance for Neisseria gonorrhoeae infections. The following information on the preferred treatment for uncomplicated gonorrhea in adults and adolescents consist of an interim guidance from the National Advisory Committee on Sexually Transmitted and Blood-Borne Infections. Alternative treatment options are also currently under review by the NAC-STBBI. Final recommendations will be available after the completion of the review currently underway. […] Over time, treatment of gonorrhea has been complicated by the ability of Neisseria gonorrhoea (NG) to develop antimicrobial resistance (AMR). Optimal treatment is important to prevent long-term complications, decrease transmission, and slow the emergence and spread of AMR. […] AMR in gonorrhea in Canada is monitored by the Gonococcal Antimicrobial Surveillance Program in Canada (GASP-Canada) and the Enhanced Surveillance for Antimicrobial-resistant Gonorrhea (ESAG) system.

• #96 Gonorrhoea infection: diagnosis and treatment – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/gonorrhoea-infection-diagnosis-and-treatment

  Microbiological culture of N. gonorrhoeae is mainly used to determine antimicrobial susceptibility, the importance of which is increasing in practice owing to emerging gonococcal resistance to antimicrobials. Gonococcal resistance is monitored through the gonococcal resistance to antimicrobials surveillance programme (GRASP) by PHE in England and Wales.

• #97 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Gram stains, cultures, and nucleic acid amplification tests (NAATs) of genital, rectal, conjunctival, pharyngeal secretions and/or other extragenital sites, as applicable, should also be obtained when DGI is suspected. […] The highest yield of N gonorrhoeae organisms in gonococcemia is from mucosal sites, including the pharynx, urethra, cervix, or rectum. […] A negative Gram stain result is not sufficient for excluding neisserial infections in asymptomatic men. […] In women with positive cervical culture results, the Gram stain results from the endocervix are 50-60% sensitive and 82-97% specific. […] The preferred method to screen for genitourinary gonorrhea is collection of vaginal swab specimens sent for NAAT assay testing. […] If the patient needs a concurrent pelvic examination, an endocervical swab is reasonable; however, in contrast with workup in males, first catch urine specimens to detect gonorrhea may detect about 10% fewer infections when compared with vaginal and endocervical swab specimens. […] Extragenital gonorrheal infections (pharyngeal and rectal infections) are often asymptomatic and are not uncommon in certain populations, such as men who have sex with men (MSM).

• #98 Gonorrhea – Infections – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/infections/sexually-transmitted-infections-stis/gonorrhea

  Gonorrhea is a sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae, which infect the lining of the urethra, cervix, rectum, or throat, or the membranes that cover the front part of the eye (conjunctiva and cornea). […] Microscopic examination, culture, or DNA tests of a sample of vaginal or penile discharge or DNA tests of urine can detect the infection. […] To diagnose gonorrhea, doctors collect a sample of discharge and send it to a laboratory. Highly sensitive tests can be done to detect the DNA of gonococci and of chlamydiae (which are often also present). […] Diagnosing gonorrhea in women is more difficult than in men, because identifying bacteria in a sample of discharge from the cervix is more difficult than from a penis. The bacteria in a sample taken from the cervix can be seen under the microscope in only about half of infected women. […] If symptoms recur or persist after treatment, doctors may take samples for culture to determine whether people are cured and may do tests to determine whether the gonococci are resistant to the antibiotics used.

• #99 Gonorrhea Causes and Diagnoses | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/infectious-disease/gonorrhea/causes-and-diagnoses

  Diagnosing gonorrhea may begin with a physical exam (including a pelvic exam for women) and a discussion of your symptoms. Tests may include: […] A urine sample is stored in an environment that encourages bacterial growth to help identify what the infectious agent is. […] Depending on your symptoms, a swab of fluid from your cervix, rectum, throat or eyes may be taken for study. […] Your sample may be checked for the chlamydia infection at the same time.

• #100 Gonorrhea Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/sexual-and-reproductive-health/gonorrhea/diagnosis.html

  How is gonorrhea diagnosed? Diagnosis of gonorrhea includes a medical history and a physical exam. Your doctor may ask you the following questions. […] Several tests can be used to confirm an infection. Your doctor will collect a sample of fluid or urine to be tested. Most tests give results in a few days. […] The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommend gonorrhea screening for all sexually active women ages 24 and younger. The CDC and USPSTF also recommend screening for women older than 24 who have risk factors for gonorrhea. […] Testing will allow gonorrhea to be quickly diagnosed and treated. This helps reduce the risk of transmitting gonorrhea. It also helps you avoid complications of the infection. […] The CDC also recommends screening for at-risk pregnant women. This can prevent them from passing gonorrhea to their babies. If a pregnant woman is at high risk for gonorrhea, she may be tested again during her third trimester.

• #101 Gonorrhea Diagnosis & Gonorrhea Treatment | OB-GYN Specialists of South Miami

  https://www.toplinemd.com/obgyn-specialists-of-south-miami/gonorrhea-diagnosis-gonorrhea-treatment/

  To determine whether you have this sexually transmitted disease, your healthcare provider will collect a sample of your cells. Then, these cells will be analyzed. […] There are two ways in which the samples may be collected. These include: Take a swab of the affected area, such as the vagina, rectum, urethra, or throat. […] Do a urine test to find gonorrhea causing bacteria in the urethra. […] Your healthcare provider may suggest testing for other STDs such as chlamydia. Namely, gonorrhea may boost your risk of sexually transmitted diseases.

• #102 Gonorrhea Diagnosis: Prevention and Management – Prof. Dr. Basak Baksu

  https://basakbaksu.com.tr/en/gonore-teshisi-onleme-yonetim/

  Tests used to diagnose gonorrhea include urine samples and swab tests. Urine samples are particularly effective in detecting urethral and vaginal gonorrhea infections. This test looks for Neisseria gonorrhoeae bacteria in a urine sample taken from a patient. Urine tests provide a rapid screening method, especially for people who do not show symptoms. […] In addition to these tests, the doctor’s examination also plays an important role in the diagnosis process. During the examination, the doctor evaluates the patient’s sexual history and makes a detailed analysis of the symptoms. Establishing a preliminary diagnosis helps to select the right laboratory tests. Screening for sexually transmitted diseases such as gonorrhea is also very important in the diagnosis process. Early diagnosis and regular screenings make it possible to control the disease and prevent its spread.

• #103 Chlamydia, Gonorrhea, and Syphilis | ACOG

  https://www.acog.org/womens-health/faqs/chlamydia-gonorrhea-and-syphilis

  Gonorrhea is the second most common STI in the United States. Gonorrhea is caused by bacteria that pass to a partner during vaginal, anal, or oral sex. […] It is common to be infected with both gonorrhea and chlamydia at the same time. […] Gonorrhea tests can be done on a urine sample or on samples taken with a swab from the vagina, mouth, throat, rectum, or the area around the cervix. You can do a self-swab of your vagina or rectum in the office of your ob-gyn or other health care professional. You may also be able to self-test at home. […] A yearly screening test is recommended if you are younger than 25 or if you are 25 and older and have risk factors for gonorrhea. […] Gonorrhea is treated with two kinds of antibiotics. The recommended treatment is an injection of one antibiotic followed by a single pill of another antibiotic. If the injection is not available, you can take two types of antibiotic pills. This treatment is also effective against chlamydia.

• #104 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Gram stains, cultures, and nucleic acid amplification tests (NAATs) of genital, rectal, conjunctival, pharyngeal secretions and/or other extragenital sites, as applicable, should also be obtained when DGI is suspected. […] The highest yield of N gonorrhoeae organisms in gonococcemia is from mucosal sites, including the pharynx, urethra, cervix, or rectum. […] A negative Gram stain result is not sufficient for excluding neisserial infections in asymptomatic men. […] In women with positive cervical culture results, the Gram stain results from the endocervix are 50-60% sensitive and 82-97% specific. […] The preferred method to screen for genitourinary gonorrhea is collection of vaginal swab specimens sent for NAAT assay testing. […] If the patient needs a concurrent pelvic examination, an endocervical swab is reasonable; however, in contrast with workup in males, first catch urine specimens to detect gonorrhea may detect about 10% fewer infections when compared with vaginal and endocervical swab specimens. […] Extragenital gonorrheal infections (pharyngeal and rectal infections) are often asymptomatic and are not uncommon in certain populations, such as men who have sex with men (MSM).

• #105 Diagnosis and Management of Gonococcal Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1115/p931.html

  Neisseria gonorrhoeae causes urogenital, anorectal, conjunctival, and pharyngeal infections. Urogenital tract infections are most common. Men with gonorrhea may present with penile discharge and dysuria, whereas women may present with mucopurulent discharge or pelvic pain; however, women often are asymptomatic. Urogenital N. gonorrhoeae infection can be diagnosed using culture or nucleic acid amplification testing. Urine nucleic acid amplification tests have a sensitivity and specificity comparable to those of cervical and urethral samples. […] First-line treatment for uncomplicated urogenital, anorectal, or pharyngeal gonococcal infections is a single intramuscular injection of ceftriaxone, 250 mg, accompanied by either azithromycin, 1 g orally, or doxycycline, 100 mg orally twice daily for seven days, to prevent bacterial resistance and address the likelihood of coinfection with Chlamydia trachomatis.

• #106 Gonorrhea Workup: Approach Considerations, Smears With Gram Stain, Isolation Via Culture

  https://emedicine.medscape.com/article/218059-workup

  Gram stains, cultures, and nucleic acid amplification tests (NAATs) of genital, rectal, conjunctival, pharyngeal secretions and/or other extragenital sites, as applicable, should also be obtained when DGI is suspected. […] The highest yield of N gonorrhoeae organisms in gonococcemia is from mucosal sites, including the pharynx, urethra, cervix, or rectum. […] A negative Gram stain result is not sufficient for excluding neisserial infections in asymptomatic men. […] In women with positive cervical culture results, the Gram stain results from the endocervix are 50-60% sensitive and 82-97% specific. […] The preferred method to screen for genitourinary gonorrhea is collection of vaginal swab specimens sent for NAAT assay testing. […] If the patient needs a concurrent pelvic examination, an endocervical swab is reasonable; however, in contrast with workup in males, first catch urine specimens to detect gonorrhea may detect about 10% fewer infections when compared with vaginal and endocervical swab specimens. […] Extragenital gonorrheal infections (pharyngeal and rectal infections) are often asymptomatic and are not uncommon in certain populations, such as men who have sex with men (MSM).

• #107 Gonorrhea: Symptoms, Causes, Prevention, Diagnosis, and Treatment

  https://www.webmd.com/sexual-conditions/gonorrhea

  Gonorrhea Diagnosis Your doctor will need to look for the bacteria in your body, including: […] Tests of your rectum, throat, vagina, or urethra […] Tests of your pee.

• #108 Gonorrhea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gonorrhea/symptoms-causes/syc-20351774

  Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. The gonorrhea bacteria are most often passed from one person to another during sexual contact, including oral, anal or vaginal intercourse. […] Make an appointment with your healthcare professional if you notice symptoms such as a burning sensation when you urinate or a pus-like discharge from your penis, vagina or rectum. […] Also make an appointment if your partner has been diagnosed with gonorrhea. You might not have symptoms, but if you have the infection, you can reinfect your partner even after your partner has been treated for gonorrhea. […] Regular screening also is recommended for men who have sex with men. Their partners also should be tested. […] Taking doxycycline within 3 days of sexual activity lowers the risk of an infection with the bacteria that cause gonorrhea. Your healthcare professional can prescribe doxycycline and any testing you need while taking the medicine. […] If you’ve been diagnosed with gonorrhea, do not have sex until after you and your sex partner have completed treatment and after symptoms are gone. This helps avoid getting gonorrhea again.

• #109 Gonorrhea: Symptoms, Treatment, Causes, and More

  https://www.healthline.com/health/gonorrhea

  If you think you could have gonorrhea or a sexual partner receives a positive test result, youll need to get a diagnosis and treatment from a healthcare professional. […] A healthcare professional can diagnose gonorrhea in a few different ways: […] Testing your urine: Often, a urine test can detect gonorrhea. […] Testing a sample of fluid: A healthcare professional may also swab your penis, vagina, throat, or rectum to get a sample of fluid for testing. This type of test requires a laboratory culture, which can take several days. […] Testing your blood: In rare instances, a healthcare professional may use a blood culture to detect gonorrhea. However, this test may not be conclusive. […] Youll generally receive results within a few days, though this can depend on your clinic or testing location. Some clinics may provide test results within a few hours.

• #110 Gonorrhea Test: What It Is, Purpose, Procedure & Results

  https://my.clevelandclinic.org/health/diagnostics/25211-gonorrhea-test

  Healthcare providers use gonorrhea tests to confirm or rule out this common sexually transmitted infection (STI). A gonorrhea test involves testing a fluid sample from the part of your body that might be infected. Common methods include urine (pee) and swab samples from your genitals, rectum or throat. […] A gonorrhea test can tell you if you have gonorrhea, a common sexually transmitted infection (STI). Testing is an important way to screen for and diagnose the condition so you dont spread it to your partners without knowing it. […] Taking a gonorrhea test is the only way to know if you have this bacterial infection. […] Healthcare providers test your body fluids for the Neisseria gonorrhoeae bacterium. If they detect this bacterium, it means you have gonorrhea. […] The most common gonorrhea testing method is a nucleic acid amplification test (NAAT). NAAT detects the genetic material of the Neisseria gonorrhoeae bacterium.

• #111 Gonorrhea Overview & Testing Information | STDCheck.com

  https://www.stdcheck.com/blog/everything-about-gonorrhea-and-gonorrhea-testing/

  Gonorrhea can be treated and cured with antibiotics. Individuals diagnosed with gonorrhea should abstain from sexual activity for one week upon finishing antibiotics. […] Whether or not symptoms are present, testing or screening for gonorrhea can be done as early as two days after exposure. The incubation times vary from person-to-person; for the most accurate results, get tested two weeks after initial exposure. If you test positive for gonorrhea, it is advised to get retested two weeks after completing treatment to be sure that all of the Neisseria gonorrhoeae bacteria is cleared from your system. […] Nucleic Acid Amplification (NAA) tests find the DNA of gonorrhea bacteria. Because it searches for the bacterias genetic material, it is very unlikely that a false-positive test result will occur. Often, the gonorrhea NAA test is a urine test.

• #112 Gonorrhea Overview & Testing Information | STDCheck.com

  https://www.stdcheck.com/blog/everything-about-gonorrhea-and-gonorrhea-testing/

  Urine samples should consist of first-catch urine (approximately 20 to 30 mL of the initial urine stream). This means collecting the very first part of the urine sample. Typically, patients should not include more than the first-catch in the collection cup to avoid diluting the sample. […] Gonorrhea Culture: Culture of a sample of body fluid, discharge, pus, swab of genital lesions, or urethral discharge (best for men when available). […] Confirmed diagnosis can be confirmed after 72 hours. […] Nucleic Acid Amplification (NAA), via either urine or swab, is considered the best option in testing for gonorrhea.

• #113 Recommendations For the Diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis, Including Extra-Genital Sites

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3763711/

  Clinicians should be aware of extra-genital mucosal sites of infection for both gonorrhea and chlamydia, specifically the oropharynx and rectum. Although no NAAT tests are FDA-cleared for use with rectal or oropharyngeal specimens for the diagnosis of gonorrhea and chlamydia, some laboratories have validated these specimen sites for clinical use. […] Aggressive STI screening of the oropharynx, rectum, and urethra should be performed in individuals who perform sexual practices involving these sites, especially in MSM. Comprehensive STI screening for chlamydia and gonorrhea should include a NAAT of the urine, rectum (for men and women who have receptive anal intercourse), and the pharynx (for men with gonorrhea and women who have receptive oral intercourse). Recognition and diagnosis of chlamydia and gonorrhea is essential to decrease the morbidity associated with these diseases, as well as prevent the transmission of other STIs including HIV.

• #114 Diagnosis and Management of Gonococcal Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1115/p931.html

  Gonococcal infection should prompt physicians to test for other sexually transmitted infections, including human immunodeficiency virus. Because of high reinfection rates, patients should be retested in three to six months. The U.S. Preventive Services Task Force recommends screening for gonorrhea in all sexually active women at increased risk of infection. […] The CDC recommends that all men who have sex with men and practice insertive anal intercourse be screened at least annually for urethral gonococcal infection with a urine nucleic acid amplification test. […] The CDC recommends that all men who have sex with men and practice receptive anal or oral intercourse be screened at least annually for rectal or pharyngeal gonococcal infection with a rectal or pharyngeal nucleic acid amplification swab test.

• #115 Chlamydial and Gonococcal Infections: Screening, Diagnosis, and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0400/p388.html

  In 2019, the U.S. Food and Drug Administration (FDA) approved the Aptima Combo 2 Assay and Xpert CT/NG, which use NAAT, for extragenital swabs of the throat and rectum. […] The recommended treatment for non-pregnant people is now doxycycline, 100 mg, twice per day for seven days. […] Nonpregnant people should be tested for reinfection approximately three months after treatment or at the first visit in the 12 months after treatment. Follow-up care recommendations are reviewed in Table 6. […] Most treatment failures are caused by reinfection from sex partners who have not received adequate treatment, rather than treatment failure from antimicrobial resistance. If symptoms do not resolve or a test is persistently positive in a situation in which reinfection seems unlikely, an infectious disease specialist and local health department should be consulted in case of possible antimicrobial resistance.

• #116 Diagnosis and Management of Gonococcal Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1115/p931.html

  Gonococcal infection should prompt physicians to test for other sexually transmitted infections, including human immunodeficiency virus. Because of high reinfection rates, patients should be retested in three to six months. The U.S. Preventive Services Task Force recommends screening for gonorrhea in all sexually active women at increased risk of infection. […] The CDC recommends that all men who have sex with men and practice insertive anal intercourse be screened at least annually for urethral gonococcal infection with a urine nucleic acid amplification test. […] The CDC recommends that all men who have sex with men and practice receptive anal or oral intercourse be screened at least annually for rectal or pharyngeal gonococcal infection with a rectal or pharyngeal nucleic acid amplification swab test.

• #117 Recommendations For the Diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis, Including Extra-Genital Sites

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3763711/

  Clinicians should be aware of extra-genital mucosal sites of infection for both gonorrhea and chlamydia, specifically the oropharynx and rectum. Although no NAAT tests are FDA-cleared for use with rectal or oropharyngeal specimens for the diagnosis of gonorrhea and chlamydia, some laboratories have validated these specimen sites for clinical use. […] Aggressive STI screening of the oropharynx, rectum, and urethra should be performed in individuals who perform sexual practices involving these sites, especially in MSM. Comprehensive STI screening for chlamydia and gonorrhea should include a NAAT of the urine, rectum (for men and women who have receptive anal intercourse), and the pharynx (for men with gonorrhea and women who have receptive oral intercourse). Recognition and diagnosis of chlamydia and gonorrhea is essential to decrease the morbidity associated with these diseases, as well as prevent the transmission of other STIs including HIV.

• #118 Diagnosis and Management of Gonococcal Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1115/p931.html

  Gonococcal infection should prompt physicians to test for other sexually transmitted infections, including human immunodeficiency virus. Because of high reinfection rates, patients should be retested in three to six months. The U.S. Preventive Services Task Force recommends screening for gonorrhea in all sexually active women at increased risk of infection. […] The CDC recommends that all men who have sex with men and practice insertive anal intercourse be screened at least annually for urethral gonococcal infection with a urine nucleic acid amplification test. […] The CDC recommends that all men who have sex with men and practice receptive anal or oral intercourse be screened at least annually for rectal or pharyngeal gonococcal infection with a rectal or pharyngeal nucleic acid amplification swab test.

• #119 Gonorrhoea

  https://www.nhs.uk/conditions/gonorrhoea/

  If gonorrhoea is not treated, it can cause serious problems including: eye infection (gonococcal conjunctivitis) if you touch your eyes after touching infected fluid from your penis or vagina. […] If you’re pregnant and think you might have gonorrhoea, it’s important to get tested and treated before your baby is born.

• #120 Gonorrhea – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/sexually-transmitted-infections-stis/gonorrhea

  In the US, confirmed cases of gonorrhea, chlamydial infection, and syphilis must be reported to the public health system. […] A cervical swab should be sent for culture or NAAT. If a pelvic examination is not possible, NAAT of a urine sample or self-collected vaginal swab can detect gonococcal (and chlamydial) infections rapidly and reliably. […] Swabs of the affected area are sent for culture or NAAT. […] An affected joint should be aspirated, and fluid should be sent for culture and routine analysis. […] Patients with skin lesions, systemic symptoms, or both should have blood, urethral, cervical, and rectal cultures or NAAT. […] Gonorrhea is diagnosed when gonococci are detected via microscopic examination using a nucleic acid-based test, Gram stain, or culture of genital fluids, blood, or joint fluids (obtained by needle aspiration).

• #121 Gonorrhea Test – Testing.com

  https://www.testing.com/tests/gonorrhea-test/

  Because many people who are infected with gonorrhea do not have any noticeable symptoms, a number of health organizations recommend regular gonorrhea screening for certain adolescents and adults between the ages of 15 and 65. […] Anyone with signs or symptoms of gonorrhea should be tested for this infection. Gonorrhea testing should also be ordered when a sex partner has been diagnosed with the disease. […] Once you have been treated for gonorrhea, it’s recommended to test for gonorrhea again three months after completing antibiotics. […] Testing for gonorrhea is typically ordered by a doctor. […] Gonorrhea testing is often performed at hospitals and doctors’ offices, as well as clinics and community health programs. […] If an at-home test comes back positive or if you have symptoms of gonorrhea, it’s important to talk with a doctor.

• #122 Urgent Care for Gonorrhea: Rapid Test & Treatment – Same Day Results | NextCare

  https://nextcare.com/what-we-treat/std-testing-screening/urgent-care-gonorrhea/

  Same-Day Gonorrhea Test and Treatment […] If you suspect you may have been exposed to gonorrhea, fast testing and treatment are crucial for managing your health and preventing complications. Gonorrhea is one of the most common sexually transmitted infections and can lead to serious health issues if untreated. […] At NextCare Urgent Care, we offer a rapid gonorrhea test with same-day results, providing an accurate diagnosis and effective treatment options in one convenient visit. […] Our walk-in gonorrhea testing is quick, confidential, and available without an appointment, allowing you to address potential exposure with immediate and discreet care. […] Initial Assessment: Our healthcare professionals will discuss your symptoms, recent exposure, and any sexual health concerns to determine the best testing and treatment plan.

• #123 Diagnosis and Management of Gonococcal Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1115/p931.html

  Gonococcal infection should prompt physicians to test for other sexually transmitted infections, including human immunodeficiency virus. Because of high reinfection rates, patients should be retested in three to six months. The U.S. Preventive Services Task Force recommends screening for gonorrhea in all sexually active women at increased risk of infection. […] The CDC recommends that all men who have sex with men and practice insertive anal intercourse be screened at least annually for urethral gonococcal infection with a urine nucleic acid amplification test. […] The CDC recommends that all men who have sex with men and practice receptive anal or oral intercourse be screened at least annually for rectal or pharyngeal gonococcal infection with a rectal or pharyngeal nucleic acid amplification swab test.

• #124 Gonorrhoea | STI Guidelines Australia

  https://sti.guidelines.org.au/sexually-transmissible-infections/gonorrhoea/

  Gonorrhoea is most commonly diagnosed in men who have sex with men, young (heterosexual) Aboriginal and Torres Strait Islander people living in remote and very remote areas, and travellers returning from high prevalence areas overseas. […] Increasing prevalence in general population, especially in women of reproductive age. […] ALWAYS collect samples for gonococcal culture before treating gonorrhoea, to determine antimicrobial sensitivity and contribute to antimicrobial resistance surveillance. However, do not delay treatment to wait for these culture results. […] Gonococcal culture should always be collected before antibiotics are administered, but treatment should be administered without waiting for culture results. […] NAATs are highly sensitive, allow for patient self-sampling and can be used in non-clinical and non-urban settings.

• #125 Gonorrhea Test – Testing.com

  https://www.testing.com/tests/gonorrhea-test/

  Because many people who are infected with gonorrhea do not have any noticeable symptoms, a number of health organizations recommend regular gonorrhea screening for certain adolescents and adults between the ages of 15 and 65. […] Anyone with signs or symptoms of gonorrhea should be tested for this infection. Gonorrhea testing should also be ordered when a sex partner has been diagnosed with the disease. […] Once you have been treated for gonorrhea, it’s recommended to test for gonorrhea again three months after completing antibiotics. […] Testing for gonorrhea is typically ordered by a doctor. […] Gonorrhea testing is often performed at hospitals and doctors’ offices, as well as clinics and community health programs. […] If an at-home test comes back positive or if you have symptoms of gonorrhea, it’s important to talk with a doctor.

• #126 Gonorrhea Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/sexual-and-reproductive-health/gonorrhea/diagnosis.html

  How is gonorrhea diagnosed? Diagnosis of gonorrhea includes a medical history and a physical exam. Your doctor may ask you the following questions. […] Several tests can be used to confirm an infection. Your doctor will collect a sample of fluid or urine to be tested. Most tests give results in a few days. […] The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommend gonorrhea screening for all sexually active women ages 24 and younger. The CDC and USPSTF also recommend screening for women older than 24 who have risk factors for gonorrhea. […] Testing will allow gonorrhea to be quickly diagnosed and treated. This helps reduce the risk of transmitting gonorrhea. It also helps you avoid complications of the infection. […] The CDC also recommends screening for at-risk pregnant women. This can prevent them from passing gonorrhea to their babies. If a pregnant woman is at high risk for gonorrhea, she may be tested again during her third trimester.

• #127 Gonorrhoea

  https://www.nhs.uk/conditions/gonorrhoea/

  If gonorrhoea is not treated, it can cause serious problems including: eye infection (gonococcal conjunctivitis) if you touch your eyes after touching infected fluid from your penis or vagina. […] If you’re pregnant and think you might have gonorrhoea, it’s important to get tested and treated before your baby is born.

• #128 Gonorrhea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gonorrhea/symptoms-causes/syc-20351774

  Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. The gonorrhea bacteria are most often passed from one person to another during sexual contact, including oral, anal or vaginal intercourse. […] Make an appointment with your healthcare professional if you notice symptoms such as a burning sensation when you urinate or a pus-like discharge from your penis, vagina or rectum. […] Also make an appointment if your partner has been diagnosed with gonorrhea. You might not have symptoms, but if you have the infection, you can reinfect your partner even after your partner has been treated for gonorrhea. […] Regular screening also is recommended for men who have sex with men. Their partners also should be tested. […] Taking doxycycline within 3 days of sexual activity lowers the risk of an infection with the bacteria that cause gonorrhea. Your healthcare professional can prescribe doxycycline and any testing you need while taking the medicine. […] If you’ve been diagnosed with gonorrhea, do not have sex until after you and your sex partner have completed treatment and after symptoms are gone. This helps avoid getting gonorrhea again.

• #129 Gonorrhea: Symptoms, treatment, and causes

  https://www.medicalnewstoday.com/articles/155653

  Gonorrhea is a common sexually transmitted infection (STI). […] Treatment is essential and is usually effective if a person has an early diagnosis. […] A person might receive a diagnosis of gonorrhea if they see a doctor due to symptoms or suspected exposure to the bacteria. […] The doctor will ask the person about their symptoms and medical history. They will also order a test, which might require a urine sample or a swab of the penis, cervix, urethra, anus, eyelid, or throat. […] At-home tests are also available. A person using an at-home testing kit sends their sample to a lab and receives the results directly. If the result is positive, they need to see a doctor for treatment, and the doctor may wish to do another test to confirm the result. […] It is crucial to use the kit exactly as instructed, or the result may not be accurate. Because the tests can vary in accuracy, it is better to see a healthcare professional, if possible. […] If one person has a diagnosis of gonorrhea or another STI, any sexual partners should also receive testing.

• #130 Gonorrhea Diagnosis: Prevention and Management – Prof. Dr. Basak Baksu

  https://basakbaksu.com.tr/en/gonore-teshisi-onleme-yonetim/

  Gonorrhea treatment is usually completed within a week using antibiotics. However, the duration of treatment may vary depending on the doctor’s recommendations and the extent of the infection. Sticking to the treatment process and progressing under the doctor’s supervision will speed up recovery. […] Gonorrhea can be reinfected even if it is treated. To reduce the risk of reinfection, it is important to practice safe sex practices and ensure that sexual partners are also treated.

• #131 Urgent Care for Gonorrhea: Rapid Test & Treatment – Same Day Results | NextCare

  https://nextcare.com/what-we-treat/std-testing-screening/urgent-care-gonorrhea/

  Follow-Up Care: We provide guidance on managing your recovery, may recommend follow-up testing to confirm that the infection is fully resolved, and offer information on preventing future STIs. […] During your visit, a healthcare provider will review your symptoms, discuss recent exposure, and answer any questions you may have. The test may involve a urine sample, swab sample, or throat swab if oral gonorrhea is suspected. Results are delivered quickly, and if you test positive, you’ll have immediate access to a personalized treatment plan. […] Early detection and gonorrhea treatment are essential to prevent the spread and long-term health risks of untreated gonorrhea. […] Regular testing, including a same-day gonorrhea test, is recommended if you’ve had potential exposure or are sexually active with multiple partners, as symptoms can sometimes be mild or go unnoticed.

• #132 Gonorrhea Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/gonorrhea-test/

  Gonorrhea is one of the most common sexually transmitted diseases (STDs). It is a bacterial infection. Anyone can get gonorrhea if they have vaginal, oral, or anal sex with someone who has the infection. The bacteria often infect the genitals, but it can infect the rectum, throat, eyes, and other parts of the body. […] A gonorrhea test looks for signs of gonorrhea bacteria in a sample of fluid from your body. The fluid used depends on the type of gonorrhea test and where the infection may be. Samples may include: […] A gonorrhea test can help find the disease early so you can get treatment before you develop lasting health problems or spread it to others. […] A gonorrhea test is used to: […] Diagnose or rule out gonorrhea when you have symptoms. […] If you are sexually active and have symptoms, you need a test to diagnose or rule out gonorrhea. The symptoms of gonorrhea depend on where the infection is. Symptoms include:

• #133 Gonorrhea differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Gonorrhea_differential_diagnosis

  Gonorrhea must be differentiated from other sexually transmitted pathogens, nongonococcal urethritis, vaginitis, cervicitis, urinary tract infections, prostatitis, and orchitis. Additionally, disseminated gonococcal infection must be differentiated from herpes simplex virus (HSV), nongonococcal septic arthritis, syphilis, HIV infection, rheumatic fever, reactive arthritis, and Lyme disease. […] Gonorrhea must be differentiated from other sexually transmitted pathogens including Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium, herpes simplex virus (HSV), and syphilis. Conditions that must be considered in the differential diagnosis of gonorrhea include: […] Disseminated gonococcal infection must be differentiated from: […] Viral culture, polymerase chain reaction (PCR), and direct fluorescence antibody confirm the presence of the causative agent.

• #134 Gonorrhea Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/sexual-and-reproductive-health/gonorrhea/diagnosis.html

  How is gonorrhea diagnosed? Diagnosis of gonorrhea includes a medical history and a physical exam. Your doctor may ask you the following questions. […] Several tests can be used to confirm an infection. Your doctor will collect a sample of fluid or urine to be tested. Most tests give results in a few days. […] The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommend gonorrhea screening for all sexually active women ages 24 and younger. The CDC and USPSTF also recommend screening for women older than 24 who have risk factors for gonorrhea. […] Testing will allow gonorrhea to be quickly diagnosed and treated. This helps reduce the risk of transmitting gonorrhea. It also helps you avoid complications of the infection. […] The CDC also recommends screening for at-risk pregnant women. This can prevent them from passing gonorrhea to their babies. If a pregnant woman is at high risk for gonorrhea, she may be tested again during her third trimester.

• #135 Gonorrhea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gonorrhea/diagnosis-treatment/drc-20351780

  You may be able to use a test that’s available without a prescription, sometimes called an at-home test, to see if you have gonorrhea. If that test shows you have gonorrhea, you’ll need to see a healthcare professional to confirm the diagnosis and start treatment. […] To determine whether you have gonorrhea, your healthcare professional will analyze a sample of cells. Samples can be collected with: […] A urine test. This can help identify bacteria in your urethra. […] A swab of the affected area. A swab of your throat, urethra, vagina or rectum can collect bacteria that can be identified in a lab. […] Your healthcare professional may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. […] Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for other sexually transmitted infections could be beneficial as well.

• #136 The laboratory diagnosis of Neisseria gonorrhoeae

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095009/

  The present article describes the laboratory diagnosis of Neisseria gonorrhoeae by culturing of the organism from different types of clinical specimens followed by confirmatory tests. The success of culture methods requires good quality collection and transport of clinical specimens. Confirmatory tests include biochemical tests, chromogenic enzyme substrate tests, immunoassays and nucleic acid methods. Nucleic acid detection methods include either amplification-based methods or nonamplification tests, and are increasingly used in clinical laboratories where a viable culture is not possible to obtain. […] Monitoring of antimicrobial susceptibilities of N gonorrhoeae is important to investigate treatment failure and to evaluate the efficacy of currently recommended therapies. […] The current preferred laboratory method for the diagnosis of N gonorrhoeae infections is the isolation and identification of the agent. Culturing isolates is important for antimicrobial susceptibility testing, surveillance purposes, detecting treatment failure and characterizing outbreaks.

• #137 Clinical manifestations and diagnosis of Neisseria gonorrhoeae infection in adults and adolescents – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-neisseria-gonorrhoeae-infection-in-adults-and-adolescents

  Clinical manifestations and diagnosis of Neisseria gonorrhoeae infection in adults and adolescents […] Gonorrhea, or infection with the gram-negative coccus Neisseria gonorrhoeae, is a major cause of morbidity among sexually active individuals worldwide. […] This topic discusses the clinical manifestations and diagnosis of gonorrhea in adults and adolescents. […] Cervicitis — The uterine cervix is the most common site of mucosal infection with N. gonorrhoeae in females. Most females with cervical gonococcal infection, up to 70 percent in some series, are asymptomatic. […] Symptomatic infection typically manifests as vaginal pruritus and/or a mucopurulent discharge. […] On examination, the cervix may appear normal or show signs of frank discharge. The cervical mucosa is often friable.

• #138 Gonorrhea guide: Treatment and follow-up – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/gonorrhea/treatment-follow-up.html

  Treatment and follow-up guidance for Neisseria gonorrhoeae infections. The following information on the preferred treatment for uncomplicated gonorrhea in adults and adolescents consist of an interim guidance from the National Advisory Committee on Sexually Transmitted and Blood-Borne Infections. Alternative treatment options are also currently under review by the NAC-STBBI. Final recommendations will be available after the completion of the review currently underway. […] Over time, treatment of gonorrhea has been complicated by the ability of Neisseria gonorrhoea (NG) to develop antimicrobial resistance (AMR). Optimal treatment is important to prevent long-term complications, decrease transmission, and slow the emergence and spread of AMR. […] AMR in gonorrhea in Canada is monitored by the Gonococcal Antimicrobial Surveillance Program in Canada (GASP-Canada) and the Enhanced Surveillance for Antimicrobial-resistant Gonorrhea (ESAG) system.

• #139 The Laboratory Diagnosis of Neisseria gonorrhoeae: Current Testing and Future Demands

  https://www.mdpi.com/2076-0817/9/2/91

  NAATs are the most sensitive techniques to detect Ng. Sensitivity and specificity of Ng NAATs is generally >95% and >99% in swabs and male first-catch urine. […] Although sensitivity of NAATs is superior to other detection methods, it should be considered that diagnostic accuracy may be affected by genetic variations and the genomic plasticity of Neisseria. […] Positive NAAT results obtained with extragenital specimens should be confirmed by detection of an alternative target to exclude false positive results due to cross reactivity with commensal Neisseria. […] The emergence of AMR strongly impairs the efficacy of Ng treatment and represents a significant clinical and public health challenge. Thus, bacterial culture should be attempted whenever possible. […] Molecular alterations causing resistance to antimicrobials used to treat Ng were well characterized, and a number of real-time PCR tests detecting resistance determinants have been published in the last years.

• #140 Gonorrhea: Symptoms, Treatment, Causes, and More

  https://www.healthline.com/health/gonorrhea

  If you believe you could have gonorrhea, its important to avoid any sexual activity until you receive a negative test result. […] If your symptoms persist for more than a few days after treatment, youll need to contact a clinic or healthcare center for retesting. […] For oral gonorrhea, youll need to follow up with a healthcare professional 1 to 2 weeks later to make sure the infection has cleared.

• #141 Gonorrhea: Symptoms, Causes, and Treatment

  https://www.verywellhealth.com/gonorrhea-8701014

  Studies have shown a single shot of ceftriaxone is over 99% effective in curing gonorrhea of the genitals or rectum. […] If a rapid test is unavailable, treatment may be given presumptively (before results are back) to avoid losing a person who may not return for their results. […] Once treated for genital or anorectal gonorrhea, you do not need a „test of cure” (TOC) to see if the treatment worked. […] After that, anyone treated for gonorrhea should be retested in three months whether or not their partners have been treated. […] Once you have been treated for genital or anorectal gonorrhea, you need to wait seven days before having sex. […] If you have been treated for pharyngeal gonorrhea, you need to wait until your TOC result is negative. […] To avoid reinfection, any sexual partners you’ve had 60 days prior to your diagnosis must be treated. […] This reduces the spread of infection, including transmission during pregnancy, and prevents otherwise avoidable complications.

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