Neisseria gonorrhoeae

• Causes gonorrhea

Epidemiology

• Resistance
  • About 50% resistance to fluoroquinolones
  • Rates of MDR gonorrhea is increasing in Canada, mostly driven by azithromycin resistance
  • XDR gonorrhea is still rare in Canada

Clinical Presentation

Anorectal gonorrhea

• Often asymptomatic
• Can cause anorectal pain, discharge, and pruritis
• Anal intercourse not required, especially in women

Disseminated gonococcal infection

• Classically presents with tenosynovitis (often of wrists) or frank arthritis, with pustular lesions
• Diagnosed with genital testing for gonorrhea, ± blood cultures or arthrocentesis

Diagnosis

• Resistance
  • MDR gonorrhea: resistance to one of azithromycin or a cephalosporin
  • XDR if resistance to both azithromycin and a cephalosporin