Gonorrhea and Chlamydia
From Encyclopedia of Sex and Sexuality
In men, the most common sexually transmitted disease is infection of the urethra (urethritis) caused by the microbes Chlamydia trachomatis and Neisseria gonorrhoeae (gonococcus). Symptoms begin within a few days after sexual exposure, with the onset of painful urination and the discharge of pus from the urethra. These symptoms may be minimal or absent in up to 10 percent of infected men. Left untreated, the gonococcus can travel up the urethra and infect the spermatic cords (epidydimitis) and testicles (orchitis). In rare instances, the gonococcus can also enter the bloodstream and potentially infect most organs and tissues, including the joints, skin, and nervous system. Symptoms of gonococcal bloodstream invasion include fever, acute arthritis, and blister-like sores on the extremities. If not treated in time or appropriately, healing results in scar tissue that may block the urethra and spermatic cord. This may often cause infertility and the formation of an abnormal opening in the penis (fistula) for passing urine.
In women, gonococci and chlamydia infect cells lining the opening into the womb (endocervix). Usually asymptomatic infections occur unless these microbes enter the uterus (womb) and ascend into one or both fallopian tubes�. There they can cause an abscess, which may block one or both fallopian tubes, causing an acute fallopian tube infection (salpingitis) and abdominal pain. If the abscess is in the right fallopian tube, it cannot be easily distinguished from an attack of acute appendicitis. Without treatment, scar tissue will form and possibly block one or both fallopian tubes. This may cause infertility or block the descent of a fertilized egg into the uterus and result in a tubal pregnancy. Male sexual partners of women who are diagnosed with salpingitis often have asymptomatic gonococcal urethral infections. An infant delivered through an infected birth canal has a good chance of having its eyes contaminated with infected maternal secretions and developing an eyesight-threatening gonoccocal eye infection (ophthalmia neonatorum) in the first week of life, or a less serious eye infection and pneumonia if infected with chlamydia. Tetracycline eye ointments are given routinely after birth to prevent these eye infections, but chlamydia pneumonia may still develop within the first three months of life and require additional antibiotic treatment.
Because as many as 50 percent of men and women with gonorrhea are also infected with chlamydia, treatment is routinely given to eliminate both types of microbes. Although penicillin was the treatment of choice for gonorrhea for many years, a large percentage of gonococcal strains have developed resistance to this drug, and the treatment of choice in the United States is now an injection of newer antibiotics such a ceftriaxone or spectinomycin. Gonococcal infections of the back of the throat (pharynx) resulting from oral sex (fellatio) are also effectively treated with a single injection of ceftriaxone. For chlamydia, a ten day course of tetracycline is recommended, except for pregnant women who are given oral erythromycin, because tetracycline can permanently damage the teeth of unborn children.
 Lymphogranuloma Venerum
Sexually transmitted chlamydia can cause the further venereal disease, lymphogranuloma venerum. This disease involves the lymphatic tissues, causing painful enlargement of the lymph nodes in the groin or the lining of the rectum and colon. Fever accompanies the swelling of lymph nodes and this condition may resemble a blocked hernia. Treatment requires an extended course of tetracycline.