Editing Neisseria gonorrhoeae (section)

=== Symptoms ===
Symptoms of infection with ''N. gonorrhoeae'' differ depending on the site of infection and many infections are asymptomatic independent of sex.<ref>{{cite journal | vauthors = Detels R, Green AM, Klausner JD, Katzenstein D, Gaydos C, Handsfield H, Pequegnat W, Mayer K, Hartwell TD, Quinn TC | title = The incidence and correlates of symptomatic and asymptomatic Chlamydia trachomatis and Neisseria gonorrhoeae infections in selected populations in five countries | journal = Sexually Transmitted Diseases | volume = 38 | issue = 6 | pages = 503–509 | date = June 2011 | pmid = 22256336 | pmc = 3408314 | doi = 10.1097/OLQ.0b013e318206c288 }}</ref><ref name="Edwards_2004" /><ref name="www.cdc.gov_2017">{{Cite web|url=https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm|title=Detailed STD Facts - Gonorrhea|date=2017-09-26|website=www.cdc.gov|language=en-us|access-date=2017-12-07}}</ref> Depending on the route of transmission, ''N. gonorrhoeae'' may cause infection of the throat ([[pharyngitis]]) or infection of the anus/rectum ([[proctitis]]).<ref name="Sherris2" /><ref name="Lev13th2" />

Disseminated gonococcal infections can occur when ''N. gonorrhoeae'' enters the bloodstream, often spreading to the joints and causing a rash (dermatitis-arthritis syndrome).<ref name="Sherris2" /> Dermatitis-arthritis syndrome results in joint pain ([[Septic arthritis|arthritis]]), tendon inflammation ([[tenosynovitis]]), and painless non-[[pruritic]] (non-itchy) [[dermatitis]].<ref name="Lev13th2" /> Disseminated infection and pelvic inflammatory disease in women tend to begin after [[Menstruation|menses]] due to reflux during menses, facilitating spread.<ref name="Sherris2" /> In rare cases, disseminated infection may cause infection of the meninges of the brain and spinal cord ([[meningitis]]) or infection of the heart valves ([[endocarditis]]).<ref name="Sherris2" /><ref name="www.cdc.gov" />

==== Male ====
In symptomatic men, the primary symptom of genitourinary infection is urethritis – burning with urination ([[dysuria]]), increased urge to urinate, and a [[pus]]-like (purulent) discharge from the penis. The discharge may be foul smelling.<ref name="Sherris2">{{cite book|url=https://books.google.com/books?id=RRRrAAAAMAAJ|title=Sherris Medical Microbiology|publisher=McGraw Hill|year=2004|isbn=978-0-8385-8529-0| veditors = Ryan KJ, Ray CG |edition=4th }}{{page needed|date=February 2015}}</ref> If untreated, scarring of the [[urethra]] may result in difficulty urinating. Infection may spread from the urethra in the penis to nearby structures, including the testicles ([[epididymitis]]/[[orchitis]]), or to the prostate ([[prostatitis]]).<ref name="Sherris2" /><ref name="Lev13th2">{{cite book | vauthors = Levinson W |title=Review of medical microbiology and immunology |date=2014 |publisher=McGraw-Hill Education |isbn=978-0-07-181811-7 |oclc=871305336 }}{{page needed|date=September 2021}}</ref><ref>{{cite web|url=https://www.std-gov.org/stds/gonorrhea.htm|title=Gonorrhea (the clap) Symptoms|publisher=std-gov.org|date=2015-04-02}}</ref>

==== Female ====
[[File:Neisseria gonorrhoeae and pus cells in a vaginal swab (Gram stain).jpg|thumb|Gram stain of a vaginal swab showing gonococci (in pairs - arrow) inside polymorphonuclear granulocytes]]

In symptomatic women, the primary symptoms of genitourinary infection are increased vaginal discharge, burning with urination ([[dysuria]]), increased urge to urinate, pain with intercourse, or menstrual abnormalities. [[Pelvic inflammatory disease]] results if ''N. gonorrhoeae'' ascends into the pelvic [[peritoneum]] (via the [[cervix]], [[endometrium]], and [[fallopian tubes]]). The resulting inflammation and scarring of the fallopian tubes can lead to infertility and increased risk of ectopic pregnancy.<ref name="Sherris2" /> Pelvic inflammatory disease develops in 10 to 20% of the females infected with ''N. gonorrhoeae''.<ref name="Sherris2" />

==== Neonates (perinatal infection) ====
In [[perinatal infection]], the primary manifestation is infection of the eye (neonatal conjunctivitis or [[Neonatal conjunctivitis|ophthalmia neonatorum]]) when the newborn is exposed to ''N. gonorrhoeae'' in the birth canal. The eye infection can lead to corneal scarring or perforation, ultimately resulting in blindness. If the newborn is exposed during birth, conjunctivitis occurs within 2–5 days after birth and is severe.<ref name="Sherris2" /><ref name="www.cdc.gov">{{Cite web|url=https://www.cdc.gov/std/tg2015/gonorrhea.htm|title=Gonococcal Infections - 2015 STD Treatment Guidelines|website=www.cdc.gov|language=en-us|access-date=2017-12-07}}</ref> Gonococcal ophthalmia neonatorum, once common in newborns, is prevented by the application of [[erythromycin]] (antibiotic) gel to the eyes of babies at birth as a public health measure. Silver nitrate is no longer used in the United States.<ref name="www.cdc.gov" /><ref name="Sherris2" />