Gonorrhoea is caused by the Gram-negative diplococcus Neisseria gonorrhoeae. Acute infection can occur on any mucous membrane surface, typically genitourinary but also rectum and pharynx. The incubation period of gonorrhoea is 2-5 days

Acquired by any form of penetrative sex that involves a mucosa lined orifice (oropharynx, vagina, anus)

Pathophysiology:

The gonococcus contains pili (extensions), these allow the gonococcus to bind to the wall of the vagina and allow it to move up towards the cervix

The WBC in the gynaecological tract are unable to develop immunological memory against the gonococci, the OPA receptors on the WBC (that usually develop immunological memory) dont work on gonococcus as they contain OPA proteins which bind these receptors and prevent them from working

• this is why every exposure to this bacteria is the same

On gram stain - gram negative cocci in pairs

Risk factors:

• Age 20-29 years
• MSM
• black ancestry
• current or prior history of STI
• multiple sex partners
• inconsistent condom use
• Partner that has the risk factors above
• Hx of sexual or physical abuse

PC