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Gonorrhoea - Management
How do I make a diagnosis in men?
Uncomplicated gonorrhoea typically causes symptoms in men.
- Symptoms usually develop after 2–5 days incubation, although they may appear after 10 days or more.
- Genital infection is most common and causes:
- Urethral discharge in 80% of men. Initially it is often scant and mucoid, becoming overtly purulent after 1–2 days.
- Pain or difficulty urinating (dysuria) in about 50% of men. Usually there is no frequency or urgency.
- No symptoms in 10% of men.
- Rectal infection is asymptomatic in most men (about 75%), but may cause acute proctitis. This presents as anal pruritus, pain and spasm of the anal sphincter (tenesmus), purulent discharge, or bleeding.
- Pharyngeal infection is asymptomatic in 90% of men, but may cause overt pharyngitis.
- Examination commonly reveals a mucopurulent or purulent urethral discharge. Less commonly, there may be epididymal tenderness or swelling, or balanitis.
- Diagnosis of gonorrhoea is confirmed by positive identification of Neisseria gonorrhoeae through culture and nucleic acid amplification tests.
[BASHH, 2005b; Handsfield and Sparling, 2005; Bignell et al, 2006]
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