The gonococcus is a bacteria responsible for sexually transmitted infections. For several years, these infections have been on the rise despite the availability of diagnosis and effective treatments. The most common infections caused by this bacteria are urethral infections (urethritis) in men as well as vaginal infections and urethritis in women.

The symptoms are often less marked in women and may go unnoticed. The risk of infection after sex with an infected partner is 75 to 90% in women and 35% with an infected partner in men. Generally, gonorrhea can be cured easily with appropriate treatment, especially when diagnosed with acute gonorrhea. Antimicrobial resistance in gonorrhea is of increasing concern, and successful treatment of gonorrhea is becoming increasingly difficult.

Neisseria gonorrhoeae, also called gonococcus, is the bacterium responsible in humans for gonorrhea, also called gonorrhea or gonorrhea. This bacterium was first observed under the microscope of German scientist Albert Neisser in 1879. This exclusively human germ is the agent of gonorrhea. It was a few years ago the most common venereal disease.

In humans, after an incubation of 3 to 5 days, appears acute urethritis (infection of the duct that connects the bladder to the penis), accompanied by a purulent urethral discharge also called “hot piss”. Left untreated, urethritis becomes chronic and may escalate to prostatitis (infection of the prostate) and epididymitis (infection of the epididymis).

In women, gonococcal infection is characterized by inflammation of the vagina and vulva. The symptoms are much less severe than in humans and the infection can sometimes go unnoticed in 75% of cases. The most classic signs of infection are purulent discharge (leucorrhoea), a feeling of discomfort or pain in the lower abdomen and sometimes signs of urethritis (especially with difficulty in urinating).

Depending on sexual practices, there may be other locations of these infections. Anal localization can occur in both men and women and presents few symptoms in the majority of cases, such as itching or inflammation. Sometimes a purulent discharge and digestive disorders and diarrhea may appear.

The bacteria can also be localized in the throat (pharynx) after contamination during oral sex. This location often goes unnoticed (we speak of portage). But because it is more difficult to treat, it is also the cause of the maintenance of the chain of contaminations between partners.

Gonorrhea is spread primarily through sexual contact, including condomless, vaginal, anal and oral sex. During sex, gonorrhea is more likely to be passed from men to women than from women to men. Patients who have previously been infected with gonorrhea may also be re-infected in the future. However, the infection can also be passed from mother to child during childbirth.

People and partners at risk generally include:

• those who have multiple sexual partners and simultaneous partnerships;
• people who do not use condoms;
• people whose partners are infected or who are partners of a subject engaging in risky sexual behavior;
• people with a history of sexually transmitted infections or who are HIV positive.

The biological diagnosis is made in the laboratory by the demonstration of gonococci by direct examination in the samples, supplemented by a culture and an antibiogram when possible. The examination generally allows the diagnosis at the acute stage in humans: examination of the “morning gout” taken before urination reveals the presence of diplococci. In women, several samples are taken systematically, from the urethra, from the endocervix with a speculum, from the anus or Bartholin’s glands in the event of inflammatory disease.

Genital gonococcal infection is usually uncomplicated. However, it can cause serious complications and facilitate the transmission of HIV. Antibiotic treatment should be administered as soon as possible. This is why your doctor will usually prescribe the treatment for you before having the laboratory results. We are talking about probabilistic treatment. However, it is necessary to respect an instruction: this treatment must always be taken after having carried out the laboratory examinations. It consists of taking antibiotics in a single dose by mouth or by intramuscular injection combined with treatment against chlamydia.

Coverage is extended to the patient’s sexual partners. It is essential to inform the patient of the risks of contamination justifying to warn his recent partners. Examination, screening and treatment of recent partners are essential.

The use of condoms is essential. Intercourse should be protected for 7 days after a single dose treatment or until the end of a multi-dose treatment and until symptoms resolve.

In general, it is recommended that the doctor recommends the use of condoms with any casual or unknown partner, regardless of sexual practices and type of intercourse.