- Gonococcus is considered to be a strict human parasite.
- Various attempts were done to infect animals but all had failed until recently when chimpanzees have been experimentally infected.
- Gonococcus is generally found only in cases of acute, chronic or asymptomatic infection but not found in healthy carriers like meningococccus.
- The latter may account for 70-80% infections in women and 5-10% in males.
- The anterior urethra gets affected in men in the initial infection and in case of female urethra and cervix of uterus gets affected.
- The infection become chronic or lead to upper genital tract or systemic complications if not treated on time or left untreated.
- Sometimes asymptomatic infections might also lead to complicated infection.
- The urethral exudate consists of gonococcus on the surface of or within epithelial cells or extracellularly, within the proportion of polymorphonuclear leukocytes in acute urethritis.
a)In case of men
- Urethra gets infected which produces a suppurative inflammation with purulent discharge.
- The cocci are present in large numbers in the discharge at an early stage, but later are scanty.
- Prostrate, seminal vesicles and epididymis may also get infected and it may also invade to the periurethral tissue producing an inflammatory reaction, periurethral abscess and subsequent stricture.
b)In case of women
- The urethra and cervix uteri are infected but the vaginal mucosa is rarely infected and the discharge is often scanty.
- The infection spreads to the vestibular glands(bartholinitis), the endometrium (endometritis) and fallopian tubes (salpingitis) and even the peritoneal cavity gets invaded.
- It occurs in case of both men and female which might be acquired exogenously by passive male homosexuals and in females, it usually spreads to the anus from the genital infection.
- Primary gonorrheal infections may help in invading the blood.
- This may results in arthritis and tenosynovitis as complications.
- Occasionally, gonococcus has also been cultivated from the joint fluid in arthritis.
- The possibility of gonococcal arthritis might be due to allergic manifestation.
- Various recent reports are present related to septic gonococcal dermatitis, usually associated with arthritis, arthralgia and fever.
- Varying size of maculo-papules to vesticulo-pustules are present in scanty as skin lesions.
- They are mostly present on the extremities or around joints and are more common in females than in males.
- Oro-genital contact may lead to gonococcal infection of the pharynx.
- It is more common in homosexual men but is also present in female and less frequently in heterosexual men.
- Asymptomatic infection may be noticed which is associated with sore throat, pharyngitis or tonsillitis.
- A persistent vulvo-vaginitis may be produced in female infants and children with involvement of rectum sometimes.
- This infection may lead to outbreaks in paediatric wards and children’s institution.
- Vulvo-vaginitis cases are rare now and are associated with sexual offences.
- Gonococcal opthalmia may result in new born infants at birth from direct infection from mother having gonorrhoea.