Gonorrhoea

Neisseria gonorrhoeae infects the urethra, cervix, rectum, throat and eyes. Symptoms, when present, arrive faster than chlamydia — typically 2 to 14 days after exposure — and include thick discharge, burning on urination and, in rectal infection, pain or discharge. Throat infections are almost always silent, which is why swabbing extra-genital sites matters for anyone who has oral or anal sex. Detection is by PCR/NAAT on urine or a site-specific swab. Gonorrhoea is the STI most affected by antimicrobial resistance: the World Health Organization tracks it as a priority pathogen, and first-line treatment has been revised repeatedly as resistance to older antibiotics spread. Current practice is a single injectable ceftriaxone dose in most guidelines, sometimes with culture and sensitivity testing to confirm the organism responds to the drug used. Untreated infection can cause pelvic inflammatory disease and infertility, epididymo-orchitis in men, and in rare cases disseminated infection affecting joints and skin. A test of cure — a repeat test after treatment — is recommended more often for gonorrhoea than for other bacterial STIs precisely because of the resistance picture.