Summary

• Neisseria gonorrhoeae is a gram-negative diplococcus bacteria that is closely related to other human Neisseria species.
• Classic presentation is a man with a urethral discharge; women are often asymptomatic, but may have vaginal discharge.
• Higher risk is attributed to those with multiple partners in recent months, known partner with gonorrhoea, drug use, prior STD, and men who have sex with men.
• If left untreated, N gonorrhoeae can disseminate to areas of the body to cause skin and synovial infections; rarer complications include meningitis, endocarditis, and perihepatic abscesses.
• High rates of antimicrobial resistance have been reported, and antibiotic treatment should be guided by local and national guidelines. The main treatment for uncomplicated gonorrhoea is a single dose of ceftriaxone.
• The treatment of N gonorrhoeae is important in the prevention of infertility, chronic pelvic pain, and ectopic pregnancy in women.
• If acquired congenitally from an infected mother, the neonate can present with ophthalmia neonatorum, which left untreated can cause blindness.