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Clinical Manifestations and Sequelae
N. gonorrhoeae causes several clinical syndromes including urogenital,
pharyngeal, and rectal infections in males and females, and
conjunctivitis in adults
and neonates. If untreated, gonorrhea is a major cause of pelvic inflammatory
disease (PID), tubal infertility,
ectopic pregnancy, and chronic pelvic pain.
Genital Infection in Men
Urethritis
is a common indicator of gonorrhea in men. Many men develop overt, symptomatic urethritis; however, asymptomatic (unrecognized) infection may occur in approximately 10% of male cases. Asymptomatic gonorrhea may act as a reservoir that perpetuates transmission in the community.
The symptoms of urethritis, when present, include a
purulent or
mucopurulent urethral
discharge which is often accompanied by
dysuria. The discharge may also be clear or cloudy.
The incubation period ranges from 1-14 days, with most men becoming symptomatic within 2-5
days after exposure.
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Complications in Men
Epididymitis is another manifestation of genital infection in men. The symptoms are unilateral testicular pain and swelling, and epididymal tenderness. Epididymitis is infrequent, but it is the most common local complication of gonorrhea infection in men. Epididymitis is usually associated with overt or subclinical urethritis. Urethral discharge may or may not be present.
Uncommon complications in men include inguinal
lymphadenitis, penile edema,
periurethral abscess or fistula, accessory gland infection (Tyson's glands),
balanitis, urethral
stricture, and
prostatitis.
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