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Pathophysiology

Type: Essay

Subject: Pathophysiology

Subject area: Nursing

Education Level: Undergraduate

Length: 3 pages

Referencing style: APA

Preferred English: US English

Spacing Option: Double

Title: Sexually transmitted disease

Instructions: select a sexually transmitted infection (sti) and do research on it. write a 3-5 page paper about the condition/issue. in the paper discuss the concepts below: what is the pathophysiology of one sti what is the etiology of the selected sti what are the clinical manifestations of the selected sti what is the treatment for the selected sti use at least one scholarly source to support your findings. examples of scholarly sources include academic journals, textbooks, reference texts, and cinahl nursing guides. be sure to cite your sources in-text and on a references page using apa format.

Focus: what is the pathophysiology of one sti what is the etiology of the selected sti what are the clinical manifestations of the selected sti what is the treatment for the selected sti

Sexually Transmitted Disease: Gonorrhea

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Sexually Transmitted Disease: Gonorrhea

Gonorrhea is a sexually transmitted infection that has existed for centuries and remains a common infection. In 2018, the United States recorded about 1.6 million new gonorrhea infections (CDC, 2022). More than half of these infections are among individuals aged between 15 and 24.  Gonorrhea ranks second as the most prevalent bacterial sexually transmitted infection in the U.S. Although contemporary antibiotics manage the condition, Gonorrhea has developed resistance to antimicrobials. Increased resistance and limited pipeline for developing new antimicrobial has undermined therapy for the disease, making gonorrhea a public health threat. Thus, the paper focuses on the pathophysiology, etiology, clinical manifestation, and treatment of gonorrhea.


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Pathophysiology of Gonorrhea

Gonorrhea infection commences with gonococci (the agent causing the infection) attaching to the epithelial cells, resulting in the cellular invasion. The infectious agent gonococci (N.gonorrhoeae) use pili (hair-like appendages) to attach to the epithelial cells. The pili cover the bacterial surfaces, and their retracting and expanding ability permits the bacteria to attach to the epithelial cells regardless of the distance (Springer & Salen, 2022). As a result, the pili promotes cellular invasion and provide the bacteria with protection and motility. Surface proteins like LOS (lipooligosaccharide), opacity-associated proteins, and Opa promote cellular attachment. LOS adhesion to the sperm cells contributes to gonorrhea infection in uninfected sexual partners from males. N. gonorrhoeae also invades the cervical epithelium. The bacterial cells interact with host cell CR3 (complement receptors type 3). The invasion is triggered when pili bind to CR3, causing the host cell to rearrange. The outcome is the emergence of ruffles, large projections that permit gonococci to invade the host cells and multiply within the invaded cells (Springer & Salen, 2022). Neisseria gonorrhoeae infects the anus, pharynx, cervix or urethra in adults and affects the newborns’ pharynx or eye conjunctiva. 

The Etiology of Gonorrhea

N. gonorrhoeae pathogen infects humans and manifests in women as cervicitis and urethritis in men. N. gonorrhoeae as an obligate pathogen must manifest illness to enhance transmission from one person to the other. The bacteria’s survival depends on its ability to infect a host because surviving outside a host is impossible. Untreated/undiagnosed gonorrheal urogenital infections cause adverse reproductive complications like infertility, pelvic inflammatory disease, endometritis, ectopic pregnancy, and life-threatening morbidity (Hill, Masters, & Wachter, 2016). Gonorrhea infection undermines a person’s immunity, leading to repeated infection. Therefore, seeking early treatment is recommended to avoid severe complications.

The Clinical Manifestations of Gonorrhea

Gonorrhea remains asymptomatic in men.  However, infected men may present with urethral infection symptoms like green/white/yellow urethral discharge or dysuria one day to a week following the infection.  Some men may also complain of scrotal or testicular pain (CDC, 2022). The presence of infections like urethritis and epididymitis may confirm gonorrhea infection in men. Women infected with gonorrhea may also be asymptomatic. Sometimes, the symptoms are nonspecific and mild and healthcare providers tend to mistake them of vagina or bladder infections. Nonetheless, the initial signs and symptoms of gonorrhea infection in women include vaginal bleeding, increased vaginal discharge, or dysuria (CDC, 2022). Women are vulnerable to developing severe complications regardless of the severity of symptoms.  Other clinical manifestation of gonorrhea in women includes cervicitis, urethritis, pelvic inflammatory disease, and pregnancy complications. Clinical manifestations present in both men and women include rectal infections like painful bowel movements, bleeding, soreness, anal itching, or discharge. 

Gonorrhea Treatment

Gonorrhea is treatable with appropriate therapy. CDC (2022) recommends gonorrhea treatment using a single 500mg intravenous or intramuscular dose of ceftriaxone. The dose can be taken with 100mg of doxycycline twice a day orally for a week. However, these prescriptions stop the infection without repairing any permanent damage caused by gonorrhea.  The healthcare sector worries about unsuccessful gonorrhea treatment due to antimicrobial resistance (Hill, Masters, & Wachter, 2016).  As a result, patients are forced to undergo follow-up testing to ensure the treatment was successful. Individuals whose symptoms continue for a few days after starting their treatment therapy should return for reevaluation. Therefore, appropriate antimicrobial therapy plus targeted and generalized prevention interventions will help prevent gonorrhea. Patient education is also important to managing the disease. For instance, patients should be informed of the need to abstain from sexual activity or use protection to avoid reinfection. 

 In conclusion, gonorrhea is a sexually transmitted infection that affects both men and women. The disease symptoms may remain asymptomatic in both men and women. However, the clinical manifestation of the disease in men includes green/white/yellow urethral discharge, dysuria, scrotal or testicular pain, and infections like urethritis and epididymitis. The disease symptoms in women include vaginal bleeding, increased vaginal discharge, or dysuria. Other infections like cervicitis, urethritis, pelvic inflammatory disease, and pregnancy complications are signs of gonorrhea infection in women. Gonorrhea is treated with antibiotics, especially ceftriaxone. However, antibiotic resistance remains a significant concern for treating and managing the condition. As a result, individuals need to be reevaluated after treatment to ensure treatment success. Patient education is also important to prevent reinfection and promote the use of protection.

References

 CDC. (2022, April 12). Gonorrhea: CDC Detailed Fact Sheet. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm

Hill, S. A., Masters, T. L., & Wachter, J. (2016). Gonorrhea-an evolving disease of the new millennium. Microbial cell, 3(9), 371-389. doi: 10.15698/mic2016.09.524

Springer, C., & Salen, P. (2022). Gonorrhea. In StatPearls [Internet]. StatPearls Publishing.