Gonorrhea screening for adolescents With High risk behavior-Teen

Summary of Recommendation and Evidence

Population	Recommendation	Grade (What's This?)
Screening of both Genders	This screening is recommended for adolescents.	B

Overview

Gonorrhea is a sexually transmitted infection (STI) caused by Neisseria gonorrhoeae bacteria. It occurs most often in teenagers aged 15 to 19 years. The infection is spread through intimate contact, including sexual interactions. When it is present in a child after the newborn period and before puberty, this infection may be a sign of sexual abuse.

Gonorrhea can also be spread from a mother to her baby during delivery.

How Is It Spread?

Gonorrhea is spread through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread from mother to baby during delivery.

People who have had gonorrhea and received treatment may get infected again if they have sexual contact with a person infected with gonorrhea.

Any sexually active person can be infected with gonorrhea. In the United States, the highest reported rates of infection are among sexually active teenagers and young adults.

Effects of Gonorrhea

Untreated gonorrhea can cause serious and permanent health problems in both women and men.

In women, gonorrhea is a common cause of Pelvic Inflammatory Disease (PID). Women with PID do not necessarily have symptoms. PID can damage the fallopian tubes enough to cause infertility. PAMF recommends yearly chlamydia testing of all sexually active women age 25 or younger.
Gonorrhea can also cause arthritis.
In men, gonorrhea can cause epididymitis, a painful condition of the testicles that can lead to infertility if left untreated.
Gonorrhea can spread to the blood or joints. This condition can be life threatening. In addition, people with gonorrhea can more easily contract HIV, the virus that causes AIDS. HIV-infected people with gonorrhea are more likely to transmit HIV to someone else.
When the infection occurs in a newborn, it most commonly causes severe eye infections.

Signs and Symptoms

Gonorrhea of the genital tract typically causes symptoms in males, but is often symptom free in females.

In boys and men, symptoms most often include:

A pus-like discharge from the penis
Pain in the penis
Burning during urination

If symptoms occur in women, they may include:

Pain or burning during urination
Bleeding connected with sexual intercourse
A yellow or bloody discharge from the vagina

Diagnosis

A number of laboratory tests can be performed to diagnose gonorrhea. Your pediatrician may take a sample of the discharge from the cervix or the penis and have it tested in the laboratory. Urine tests can also be conducted. If a newborn has discharge from the eye, it is tested by microscopic examination and culture.

When gonorrhea is diagnosed, the patient should be tested for other STIs such as syphilis, HIV, chlamydial infection, or hepatitis B. In fact, gonorrhea and chlamydial infections often occur at the same time. The sexual partners of the infected person should also be tested for STIs.

Prevention

The surest way to avoid transmission of sexually transmitted infections is to abstain from sexual intercourse or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea.

Any genital symptoms such as discharge, burning during urination, or unusual sore or rash should be a signal to stop having sex and to see a doctor immediately. If a person has been diagnosed and treated for gonorrhea, he or she should notify all recent sex partners so they can see a health care provider and be treated.

This will reduce the risk that the sex partners will develop serious complications from gonorrhea and will also reduce the person's risk of becoming re-infected. The person and all of his or her sex partners must avoid sex until they have completed their treatment for gonorrhea.

Treatment

Several antibiotics can successfully cure gonorrhea in adolescents and adults. However, drug-resistant strains of gonorrhea are increasing in many areas of the world – including the United States – and successful treatment of gonorrhea is becoming more difficult.

Because many people with gonorrhea also have chlamydia – another sexually transmitted infection – antibiotics for both infections are usually given together. Persons with gonorrhea should be tested for other STIs.

It is important to take all of the medication prescribed to cure gonorrhea. Although medication will stop the infection, it will not repair any permanent damage done by the disease.

Prognosis

When gonorrhea is treated quickly and properly, the infectious organisms can be eliminated and complications can be avoided.