Week 4 Journal EntryGonorrhea InfectionGonorrhea is one of the most common bacterial sexually transmitted infections (STI), and most infected females are asymptomatic. If left undiagnosed and untreated, gonorrhea mayspread to sexual partners and may lead to long term and serious health complications including pelvic inflammatory disease (PID), and infertility (Sood et al, 2014).Case Study:A H is a 22-year-old female who presented to the primary care clinic complaining of a urinary tract infection (UTI). She complained of dysuria, increased clear to greenish colored vaginal discharge, painful intercourse, and spotting between periods. Upon further work up, shewas found to have a gonorrhea infection.Key Signs and SymptomsThis patient presented with specific signs and symptoms, and she was concerned about possibly having a UTI. Gonorrhea and Chlamydia are often asymptomatic, or present with mild symptoms that are often mistaken for a UTI (ACOG, 2016). The USPSTF recommends screening for Chlamydia and Gonorrhea in sexually active women 24 years old and younger and in older women who are at an increased risk of infection (2014).This patient may have had a UTI, but her high-risk-age, her symptoms, as well as the recommended screening guidelines suggested the possibility of a STI. Specifically in her presentation, increased and discolored vaginal discharge, painful intercourse, and spotting between periods lead us to suspect chlamydia and gonorrhea over a UTI. This suspicion was
confirmed using a nucleic acid amplification test from a urine sample which showed gonorrhea; we also performed an oropharyngeal swab which was negative. Up to 20 percent of women with cervical gonorrhea are also infected with pharyngeal gonorrhea (Mayor, Roett, & Uduhiri, 2012). The use of nucleic acid amplification tests (NAATs) has been shown to provide enhanced diagnosis of gonorrhea in female patients (Sood et al, 2014). Delivering the Findings and Patient’s ReactionDelivering the diagnosis was a challenging task for me. I had no previous experience withthis kind of news, and I took the time to prepare myself and ensure that I present the findings tothe patient in a professional way and avoid making her feel judged or uncomfortable in any way.Upon delivering the news, the patient became very upset, she expressed surprise with the diagnosis, but also verbalized that she thinks she knows how she contracted it. We reassured the patient that this condition is easily treatable, and we encouraged her to quickly inform all possible sexual partners to come in for treatment.