Gonorrhea, a threatening infection in gynecology and obstetrics
Alessandra Graziottin1,2 – , Elena Boero1– , Chiara Limongi1
1 – Graziottin Foundation for the treatment of pain in women – Onlus
2 – Center of Gynecology and Medical Sexology, H. San Raffaele Resnati Milan
Corresponding author: Alessandra Graziottin
Gonorrhea is the second most common sexually transmitted bacterial infection worldwide after chlamydia. Women present a different and unsuspected gender vulnerability, with diagnostic and therapeutic delays that can and must be avoided. Gonorrhea is caused by the vertically and sexually transmitted bacterium Neisseria gonorrhoeae, whose prevalence is aggressively increasing worldwide. Diagnostic and therapeutic timeliness in women is hampered by lack of specificity and short duration of cervico-vaginal symptoms, modesty of urethral symptoms (urethritis), and limited knowledge of both oral and anal infections. Another element of insidiousness is the underestimation of the risks that gonorrhea entails, in terms of infertility and obstetric complications, chronic pelvic pain and injuries in distant organs, including conjunctivitis and gonococcal arthritis. The danger of the diagnostic delay is also expressed in the persistent infectivity of the patient, who continues infecting his/her sexual partners, and the fetus, in case of pregnancy. Growing antibiotic resistance is another serious alarm. The aim of the work is: to identify the key points for timely and effective diagnosis and treatment of gonorrhea in gynecology and obstetrics, with a focus on vaginal, endometrial, tubal, and pelvic; amniotic, placental, and fetal; oral and systemic vulnerability. Diagnostic difficulties and the current lack of a vaccine will be analyzed. The ultimate goal is to enhance the diagnostic and therapeutic timeliness of the gynecologist, in order to avoid both persistent underlying infectivity and multiple long-term complications.
Keywords: gonorrhea; sexually transmitted infection; gender vulnerability; infertility; antibiotic resistance.
Available in LRIOG Nr.2 – 2021