Gonococcal Urethritis

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This is an acute inflammatory condition of the columnar epithelial lining of the urethra. It is caused by a gram- negative intracellular diplococcus, Neisseria gonorrhoea.

Clinical Features
The incubation period is 3 to 5 days and the patient will present with dysuria (difficulty in micturition), followed by urethral discharge of copious, a mucoid fluid which sometimes contains puss. Frequency and urgency may develop as the disease spreads to the posterior urethra. Examination of the discharge shows a purulent, yellowish-green urethral discharge. The lips of the meatus may be red and swollen.

Complications

These include:

Acute epididymo-orchitis: This is an important complication, which is usually unilateral swelling and tenderness of the testis and epididymis. Bilateral epididymo-orchitis may result in sterility.

Urethral strictures: This is a late complication occurring in cases which are treated inadequately or not at all. This could occur 10 to 25 years after initial infection or in cases of recurrent infections.

Disseminated Gonococcal Infection: This is an arthritis-dermatitis syndrome in which the patient presents with a mild febrile illness, malaise, migratory polyarthralgia or polyarthritis) and a few pustular skin lesions.