Primary gonorrhea infection - Anogenital in
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Synopsis
The incubation period of N gonorrhoeae is short. The average time from infection to symptom onset lasts approximately 2-7 days.
In boys, the manifestations are similar to those seen in adults, and the most common clinical manifestation is anterior urethritis, with purulent urethral discharge and dysuria. Complications include epididymitis, vesiculitis, and prostatitis, which occur via local extension. Epididymitis may manifest as unilateral testicular edema and pain together with the features of urethritis.
Notably, proctitis and pharyngitis occur in both sexes via direct mucosal infection, and are strongly associated with sexual assault in non-sexually active children; however, infections of the rectum and pharynx are often asymptomatic.
Neonates born to infected mothers commonly manifest a purulent conjunctivitis called ophthalmia neonatorum, which is a major cause of blindness in the developing world. In the United States, the rate of this infection is low due to routine screening of mothers and preventive application of antibiotic ointment immediately after birth. Neonatal infection can also lead to sepsis with invasive and disseminated gonococcal infections, including meningitis and arthritis.
In children and adolescents, disseminated and invasive gonococcal infections are uncommon.
Related topics: disseminated gonorrhea, gonococcal conjunctivitis
Codes
ICD10CM:A54.9 – Gonococcal infection, unspecified
SNOMEDCT:
15628003 – Gonorrhea
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Differential Diagnosis & Pitfalls
For boys – If there are concerns about sexual activity or assault, other STIs are the main concern, including chlamydia, genital herpes infection, or other forms of urethritis (only if the direct examination and culture are negative). Presentation can range from asymptomatic to penile discharge to systemic symptoms.- Chlamydia trachomatis infection
- Other forms of urethritis only if the direct examination and culture are negative.
- Genital herpes infection
- Syphilis
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Last Reviewed:09/12/2021
Last Updated:09/19/2021
Last Updated:09/19/2021