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Hi stemsocial readers!!

It's been a long time since I wrote a post on stemsocial and on hive in general because I have been preparing for a very challenging exam.

I am done with the exam and I passed. So I am partially back as I have to prepare for the next stage of the exam that is set to happen in May.

Enough of my life, let's jump right into the post of the day.

#### Just a small story

<center>![image.png](https://files.peakd.com/file/peakd-hive/bhoa/23vhwwe8e35brqCXUDUNNrbKt7tm3uXY1UNjW3V8ep9DoSm4RgJJ79j7vJascr89Xd4zW.png)
[Pexels](https://www.pexels.com/photo/man-in-black-shirt-and-gray-denim-pants-sitting-on-gray-padded-bench-1134204/)</center>
A few days ago, I went to consult in a clinic very close to my house.

I see all kinds of patients as I am yet to specialize in a particular field.

So there was this patient who came into the office. He was a very gentle looking man , tall and huge.

He came complaining of pain while urinating. He also complained of pus coming out of his penis while peeing.

Based on these complaints, I was almost sure he had **Gonorrhoea**. 

Just not to be too fast to hit the diagnosis, I asked how many sexual partners he had and he said he is a Christian, bla bla bla...


I paraphrased my question and dug deep, he then confessed that he had about 3 sexual partners 

That confirmed my diagnosis.


So in today's post, I will be talking about a very common disease called **Gonorrhoea..**

Gonorrhoea is a sexually transmitted infection caused by a bacteria call Neisseria gonorrhoeaae.




#### How common is Gonorrhoea??
According to a study done by the CDC, approximately 1.6 million new gonococcal infections occurred in the United States in 2018, and more than half occur among young people aged 15-24.
Studies also observed gonorrhoea to be the second most reported bacterial sexually transmitted infection. I think herpes is the commonest STI although it is viral.

It is important to note that majority of cases of gonorrhoea are asymptomatic and  so the reported cases are still underreported.


#### How does one get gonorrhoea?
Gonorrhoea is a sexually transmitted infection like every other STI like HIV , syphilis, and the likes.

They are mainly gotten through the same way which includes;

  - ***having unprotected  vaginal , anal or oral sex.***
  - ***it can also be transferred from mother to child via the birth process.***
 

#### How does one if he or she has gonorrhoea??

<center>![image.png](https://files.peakd.com/file/peakd-hive/bhoa/23x1FkNGkvauwzAVEsidf1uNTyZSVR9BFoB4bsqrgDLAMMbRcn6qTXeuEMALepi9AJGvX.png)
By Sicherintim - Wie sieht Gonorrhoe aus?, CC BY-SA 4.0, [wikimedia](https://commons.wikimedia.org/w/index.php?curid=128696487)</center>

Like I said earlier, it can be asymptomatic and that's  why it is very underreported.

However, when there are symptoms, the symptom presentation is based on the gender affected and the symptoms can be very annoying.


It is very important to note that gonorrhoea and most STIs are more silent in women than in men.

From the story above , it's obvious that gonorrhoea can present with urinary symptoms like painful urination. It also present with pyuria which means  pus coming out of the penis. This presentation is what brings most men to the hospital. The pain might be bearable but when the pus starts coming out, it becomes embarrassing.

For women, they present with vaginal discharge that could be yellow, green or even brown.. 
They could also present with abdominal pain that is located in the lower part of the tummy. Some of them present with menstrual abnormalities too.

A few of them have pain on urination which they describe as a burning sensation. 

The discharge and pain is what warrants their presentation to the hospital because of how discomforting it can be.



#### How is gonorrhoea treated?
 Having an STI can be very embarrassing and a lot of people try to avoid seeking care. Some decide to just go to an unskilled person to seek care. For example, the young man who came to me had gone to a drug store owned by some random person and got suboptimal care.


The truth about treatment for this condition is that it is a very easy bug to treat and if caught early, it doesn't cause any problem.


The treatment for gonorrhoea is simply a course of antibiotics. I personally love to give a dose of intravenous antibiotics and then continue with oral antibiotics for a week. Antibiotics like ceftriaxone or drugs that belong to the same class are very good in attacking *Neisseria gonorrheae*

According to CDC, when treating for gonorrhoea, patients should also be treated for chlamydia as there is most time a coinfection.

These two bugs have been implicated in the cause of a scary condition known as pelvic inflammatory disease(PID).

Also, when treating a patient, it is important tat all the partners are treated to prevent recurrent infection.

Another important thing to be done is to screen for other STI since they basically get transmitted through the same route.

#### When should you return to sex?
After a 7 days course of antibiotics, you are expected to wait for an extra week before you can commence unprotected sex. Protected sex is allowed even with the infection as long as there is proper use of condoms or dental dams,.



#### What are the complications of gonorrhoeal infection?
Well, complications usually don't arise but when they do, they are as a result of either ***not treating properly, recurrent infection or incomplete treatment.***

One of the serious complication of this infection is pelvic inflammatory disease(PID). A condition that present in women as serious abdominal pain with fever and copious vaginal discharge. The problem with PID is not the pain but its the fact that it can cause a sequelae of events.

<center>![image.png](https://files.peakd.com/file/peakd-hive/bhoa/242P6PbuSjM6oBENkKgLanmKtEbRtcj3CJ9aUTHEkuF6jHkQBE9VqPbfFS9bzZUALrMV4.png)
By BruceBlaus - Own work, CC BY 3.0, [wikimeda](https://commons.wikimedia.org/w/index.php?curid=30462650)</center>
One of the sequelae is infertility. PID causes inflammation of the fallopian tubes and this causes scarring of the tubes. When the tubes are scarred, the eggs cannot move from the fallopian tubes to the womb(uterus) leading to difficulty with conceiving.

Sometimes with the scarring, the eggs might be able to move a bit within the fallopian tube and when the fertilized egg gets stuck due to scarring. it continues to grow within the tubes and this is what gives rise to a very serious condition called ectopic pregnancy.

In men, semen travels through a tube to the penis which is then ejaculated. Complicated gonorrhea can cause scarring of the tube annd so this leads to difficulty with transport of the sperms leading to infertility.

<center>![image.png](https://files.peakd.com/file/peakd-hive/bhoa/Enz1cwfU4ceSeGaBZDJoVzaCLb4aVFdhb7iDxqRvvYrKHKyCb4MEjmejqoiShQiLDco.png)
By CDC/ J. Pledger - This media comes from the Centers for Disease Control and Prevention&#039;s Public Health Image Library (PHIL), with identification number #3766.Note: Not all PHIL images are public domain; be sure to check copyright status and credit authors and content providers.العربية | Deutsch | English | македонски | slovenščina | +/−, Public Domain, [wikimedia](https://commons.wikimedia.org/w/index.php?curid=901973)</center>

Another sequelae is something called neonatal conjunctivitis in which a mother passes the infection to her child as the child passes through the vagina. They usually present with pus on the eye like what is been depicted in the picture above. The condition is called ophthalmia neonatorum. Treatment is usually with topical and oral erythromycin for 14 days.

A final and rare complication is the fact that it can infect the bone causing a serious infection called osteomyelitis. If you know an orthopaedic surgeon, you can ask them about this condition. They don't like to hear about it(*at least the ones I know*)

### To sum it up

Gonorrhoea is an STD with a lot of complications. IT is basically gotten by unsafe sex practices and it is usually more common in people aged 15=24. It usually present with discharge and pain while urinating. Treatment involves a week course of strong antibiotics. 

Finally, people who are sexually active and are wihin the age bracket should get tested every year for gonorrhea as it is most times asymptomatic.

Thank you for reading


#### References
- [CDC](https://www.cdc.gov/std/gonorrhea/default.htm)
- [WHO](https://www.who.int/news-room/fact-sheets/detail/multi-drug-resistant-gonorrhoea)
- [Health;ine](https://www.healthline.com/health/gonorrhea)
- [Medical news today](https://www.medicalnewstoday.com/articles/chlamydia-and-gonorrhea)</div>