Fast Five Quiz: Sexually Transmitted Infections

Michael Stuart Bronze, MD


February 28, 2022

Gonorrhea is a purulent infection of the mucous membrane surfaces caused by Neisseria gonorrhoeae. The most common site of gonococcal infection in women is the cervix, followed by the urethra, rectum, and pharynx. The incubation period for gonorrhea is usually 2-7 days after exposure to an infected partner. If symptoms develop, they often manifest within 10 days of infection.

On the basis of CDC guidelines and the United States Preventive Services Task Force recommendations, NAAT assay is the test of choice to evaluate for urogenital infections (including gonorrhea) in both men and women, whether symptomatic or asymptomatic. A 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. Although bacterial culture has high sensitivity specificity, is relatively low cost, is suitable for different types of specimen sources, and can be used for epidemiologic and resistance testing purposes, it is difficult to maintain the bacteria's viability during transport and storage in various settings. Another drawback is that 24-72 hours is needed before a preliminary culture result may return.

The updated CDC guidelines for the treatment of uncomplicated gonococcal infection of in adults and adolescents is:

  • Ceftriaxone: 500 mg intramuscularly (IM) in a single dose for persons weighing < 330 lb (< 150 kg); 1 g ceftriaxone for persons weighing ≥ 330 lb (≥ 150 kg)

  • Chlamydial infection not excluded: treat for chlamydial infection with doxycycline (100 mg orally twice daily for 7 days)

  • Alternative regimens if ceftriaxone not available: gentamicin (240 mg IM in a single dose) plus azithromycin (2 g orally in a single dose) or cefixime (800 mg orally in a single dose); if chlamydial infection is not excluded, treat for chlamydial infection with doxycycline (100 mg orally twice daily for 7 days)

Learn more about gonorrhea.


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