Individuals, who have contracted gonorrhea, a sexually-transmitted disease, are susceptible to gonococcal arthritis. If not treated promptly and effectively, this inflammation of the joints can be debilitating. Sexual relations, as well as everyday normal activities can become significantly impaired, if this infection is not dealt with immediately.
Women, more so than men, are affected with this type of arthritis. In fact, women are 60 to 90% more at risk than men, who are only 20%. Sexually active teenage girls are commonly afflicted with this condition.
Some of the common sites that can be affected can include: the cervix, urethra, rectum, and pharynx. Some patients may be asymptomatic, and not show any signs of having this type of sexually-transmitted infection, and this can delay treatment.
In addition to inflammation of the joints, that causes severe pain (mainly in the ankles, knees, and wrists) skin rashes are also a common symptom of gonococcal arthritis. Other symptoms can include: pain in the lower abdomen, fever, and a burning sensation during urination. According to the experts, discharge (from the penis or vagina) is also a common symptom of this condition. Pain, during intercourse is also a known symptom that is associated with this type of infection. It is important to note, that babies can contract gonococcal arthritis during the birthing process.
There are Two Types of Gonococcal Arthritis
One type includes skin rashes, as well as pain in large joints (such as the ankle, knee, and wrists). The second type (which is the less common form) involves the spread of bacteria through the blood (known as disseminated gonococcemia).
Based on the symptoms list, a doctor may order medical tests that include (but not necessarily limited to): cultures of the throat, blood and urine tests, as well as tissue samples. More specifically, a complete blood count should be obtained by a trained medical professional, as gonococcal arthritis patients often have a mild case of leukocytosis. In many cases, the erythrocyte sedimentation rate (ERS) is raised.
A culture of the site of the infection is one of the most important tests, to determine a conclusive diagnosis. Other cultures necessary for diagnosis include: samples obtained from the pharynx, urethra, rectum, and cervix. These culture results help to identify a particular strain of infection, and aid in better prescribing the right antibiotic to treat the infection. Tests for other sexually-transmitted diseases, such as chlamydia, syphilis and hepatitis should also be conducted.
Antibiotics are usually the first course of treatment, and the joint should be rested, to avoid overuse and reduce pain. Drainage of the joint is usually the next course of action. If the patient does not significantly show signs of improvement, surgery is a considered option. Ceftriaxone, every eight hours, should be administered via IV, and then after a couple of days, the patient is usually shifted from an IV drip to an oral antibiotic, such as cefixime. Individuals, who are pregnant, should be treated with azithromycin or cephalosporin. Meningitis is a rare complication associated with gonococcal arthritis, and if this is the case, a more aggressive type of treatment may be warranted. When caught early and adequately treated, patients can expect to recovery fully from this infection.
According to the Center of Disease Control (CDC), gonorrhea is the second-most common communicable disease in the United States, with more than 330,000 reported annual cases (this number is grossly under estimated, due to the fact that many cases go unreported). Gonococcal arthritis is a rare complication that is associated with this type of sexually-transmitted infection. In the United States, gonococcal arthritis is a very common for septic arthritis. In western areas of Europe, on the other hand, gonococcal arthritis is not as common, because this type of sexually-transmitted infection has declined by 70% in the last 20 years.
If gonorrhea is contracted, the incubation period is approximately two to seven days, after being exposed to the infection. When you seek medical attention, be prepared to have a history of sexually-transmitted diseases (including viral hepatitis and HIV), as well as the type of contraception that was used, a list of past sexual partners, and a history of sexual assaults (if applicable). Women should also know the date of their last menstrual cycle, and a history of pregnancies.
To prevent gonococcal arthritis, sexual abstinence is recommended. Practicing safe sex by using a condom can also severely reduce the risk of getting this infection.
If contracted, gonococcal arthritis is curable, but it has been observed by the CDC, that the bacteria (known as Neisseria gonorrhoeae) are becoming more resistant to drugs on the current market. Due to this increasing resistance, future outbreaks of this infection could result in permanent and ongoing joint pain that cannot be effectively treated.
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