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Gonorrhea infection

Última revisão: 20 Aug 2025
Última atualização: 02 May 2025

Resumo

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • urethral discharge in men
  • tenderness and/or swelling of the epididymis
  • mucopurulent or purulent exudate at the endocervix
Todos los datos

Otros factores de diagnóstico

  • pelvic pain in women
  • urethral irritation in men
  • dysuria in men
  • tenderness and/or swelling of testis
  • tenderness and/or swelling of prostate
  • anal pruritus
  • mucopurulent discharge from the rectum
  • rectal pain
  • tenesmus
  • rectal bleeding
  • vaginal discharge
  • cervical friability
  • uterine, adnexal, or cervical motion tenderness
  • uterine mass
  • anterior cervical lymphadenopathy
  • conjunctivitis
  • fever
  • skin lesions (papules, bullae, petechiae, or necrotic) at extremities
  • polyarthritis
  • purpuric rash
  • positive Brudzinski and Kernig sign
  • seizures
  • focal cerebral signs
  • murmur
  • ophthalmia neonatorum
  • rhinitis
  • urethritis (infantile)
  • vaginitis
Todos los datos

Factores de riesgo

  • age 20 to 24 years
  • men who have sex with men (MSM)
  • black ancestry
  • current or prior history of STI
  • multiple recent sex partners
  • inconsistent condom use
  • risk factors of partner
  • history of sexual or physical abuse
  • substance use
  • past incarceration
  • high-morbidity community
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • nucleic acid amplification test (NAAT)
  • culture
  • urinalysis in men
  • Gram stain of urine sediment
  • Gram stain of urethral discharge
  • HIV test
  • syphilis test
Todos los datos

Pruebas diagnósticas que deben considerarse

  • transvaginal ultrasound
  • pelvic CT/MRI
Todos los datos

Algoritmo de tratamiento

Agudo

nonpregnant >45 kg: urogenital/anorectal or pharyngeal infection (excluding complicated genitourinary infection)

nonpregnant >45 kg: complicated genitourinary infection

nonpregnant >45 kg: disseminated gonococcal infection

pregnant: uncomplicated urogenital/anorectal or pharyngeal infection (excluding complicated genitourinary infection)

pregnant: complicated infection

neonate

child ≤45 kg

En curso

recurrent/resistant: urogenital/anorectal infection or pharyngitis

Colaboradores

Autores

Sheldon Morris, MD, MPH

Assistant Professor

Division of Infectious Diseases

Department of Medicine

UCSD Antiviral Research Center

Division of Family Medicine

Department of Family and Preventive Medicine

UCSD La Jolla Family and Sports Medicine

San Diego

CA

Divulgaciones

SM has received research funding via his institution from Merck, Gilead Sciences, National Institutes of Health, California HIV/AIDS Research Program, and California Institute for Regenerative Medicine. He has completed a National Institutes of Health contract for research study on the Visby Medical Sexual Health Test. He holds stock in Bristol Myers Squibb and Pfizer. He is a co-founder of Aspera Biomedicines and a consultant for Primmune Therapeutics. SM is an author of a number of references cited in this topic.

Revisores por pares

Vani Dandolu, MD, MPH

Associate Professor

Ob/Gyn and Urology

Director

Division of Urogynecology

Associate Residency Program Director

Temple University Hospital

Philadelphia

PA

Divulgaciones

VD declares that he has no competing interests.

Eva Jungmann, FRCP MSc

Consultant in Genitourinary and HIV Medicine

Archway Centre & Mortimer Market Centre

London

UK

Divulgaciones

EJ declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Centers for Disease Control and Prevention. Gonococcal isolate surveillance project (GISP). 30 August 2021 [internet publication].Texto completo

Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.Texto completo  Resumen

Miller WC, Ford CA, Morris M, et al. Prevalence of chlamydial and gonococcal infections among young adults in the United States. JAMA. 2004 May 12;291(18):2229-36.Texto completo  Resumen

Centers for Disease Control and Prevention. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae - 2014. MMWR Recomm Rep. 2014;63(RR-02):1-19.Texto completo  Resumen

Fifer H, Saunders J, Soni S, et al. 2018 UK national guideline for the management of infection with Neisseria gonorrhoeae. Int J STD AIDS. 2020 Jan;31(1):4-15.Texto completo  Resumen

US Preventive Services Task Force; Davidson KW, Barry MJ, Mangione CM, et al. Screening for chlamydia and gonorrhea: US Preventive Services Task Force recommendation statement. JAMA. 2021 Sep 14;326(10):949-56.Texto completo  Resumen

World Health Organization. WHO guidelines for the treatment of Neisseria gonorrhoeae. 2016 [internet publication].Texto completo

Centers for Disease Control and Prevention. Guidance on the use of expedited partner therapy in the treatment of gonorrhea. 18 August 2021 [internet publication].Texto completo

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Gonorrhea infection images
  • Diferenciales

    • Chlamydia infection
    • Trichomonas
    • Other infectious causes of urethritis, cervicitis, pelvic inflammatory disease (PID), and epididymitis
    Más Diferenciales
  • Guías de práctica clínica

    • Reducing sexually transmitted infections
    • Guidance on the use of expedited partner therapy in the treatment of gonorrhea
    Más Guías de práctica clínica
  • Folletos para el paciente

    Gonorrhea

    Más Folletos para el paciente
  • Videos

    Intramuscular injection animated demonstration

    Más vídeos
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