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GONORRHEA
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Hello Dr. Gian,
I am doing a case study for my Microbiology class. I am having huge problems with doing a diagnoses of the symptoms that were given:
22 year old moderately sexually active female with slight fever- 38.5C frequent urination burning on urination vaginal discharge (no color or smell was indicated) small lesion on the labia urine analysis pH of 8.2 some white cells and few red blood cells and protein found in urine smear of Gram-negative cocci.
I first thought that the lesion was a dead give away for syphilis, however the smear of the Gram-negative cocci (not a sign of syphlis) leads me to believe that I am wrong. I am now leading to believe that it is Gonorrhea, but the lesion is throwing me off. What I am asking is if it is uncommon to have a lesion with gonorrhea or if it is possible to obtain one. Your help on this would be greatly appreciated. Thanks.
Sincerely,
Dan
Hi,
the young woman has a urethritis and vaginitis and a Gram negative coccus in the urine smear. Bacteria usually increase the pH as they break down urea to ammonia. I would say that your bet on Gonorrhea is a good one. Good luck.
Dr. Gian
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From:
Sent: 9/22/2004 11:00 PM
To: drgian
Subject:
Dear Dr. Gian:
My girlfriend and I have been together for nine months. We had sex for the first time on January 18, 2004. On January 26th, she went to the doctor because she suspected that she might have a bladder infection. She was prescribed an antibiotic, and then the medication was changed to another antibiotic. We both have been monogamus the entire time of our relationship, but on October 4th my girlfriend suspected another bladder infection. She visited the doctor on October 5th and was prescribed Ciprol 1000 mg. for seven days. During that same period, I had a slight discharge and soreness in my mouth, but no pain when I urinated. I visited the doctor and explained the situation with the doctor. She ordered urine cultures for Chlamydia and Gonorrhea. When I got my results, I tested positive for Gonorrhea. We have both been treated for this. My question is what is the possibility that this was a result of being infected by a partner we had before we were together? This last time that she had sex with someone else was August 13, 2003; my last time was January 17, 2004.
In 1974, while in the military, I was diagnosed and treated for Gonnorrhea. The symptoms were very apparent: discharge, burning sensation during urination, and pain. Can you explain why my symptoms this time were so mild, when the first time they were so definitive?
Thank you,
Hi,
it seems to me that the most important piece of information is that you had a previous infection with the Gonococcus bacterium in 1974. Re-infection...I have seen this over and over. It may be a matter of behavior in repeating the same mistakes or it may be a matter of poorly treated primary infection, or a sign of antibiotic resistance, as recently reported in Hawaii and California, or a combination of these factors bur this is not a uncommon situation both for Gonorrhea and Chlamydia.
You do not say whether your girlfriend was also diagnosed for GC. However I see that she took a Cipro dose enough for an army and so she should be all right. May be you want to consider retesting your urine in a couple of months.
Be well.
Dr. Gian
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From:
To: Dr.Gian
Sent: Friday, November 07, 2003 8:55 PM
Subject: (no subject)
i had unprotected sex a few times with my boyfriend to make a long story short now his ex is saying he gave her gonnorrhea i have no symptons nor dfoes he it would of been about 8 months ago that he had been exposed does it usually take that long for symptons to show?
Hi,
Possible but unlikely. I like short stories. You: no symptoms. Partner: no symptoms. Ex with GC. What do you mean " he had been exposed" and how does it relate to your question about symptoms?. GC symptoms appear within few days from the contact with an infected partner. However situations are different and people poorly treated can carry on the bug for months with little or no symptoms. I don’t like medications very much but STD is one of the situation where may be is better to overdo than underdo when it comes to medicines. The other side is that GC is developing resistance to our best weapons like in Hawaii and California where we lost a great antibiotic for GC because of the bug adaptation to it. Well, any living thing wants to survive !!!
Take good care.
Dr. Gian |
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