Gonorrhea: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

• General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
  • Inspection (viewing).
    • Skin, mucous membranes, sclera (white part of the eye) [conjunctivitis (inflammation of the conjunctiva); rare: Blepharoconjunctivitis (severely swollen, reddened eyelids, creamy discharge from the eye; in man: arthritis (inflammation of the joints) with accompanying exanthema (rash)]
  • Auscultation (listening) of the heart [due topossible secondary disease: endocarditis (endocarditis)]
• Gynecological examination
  • Inspection
    • Vagina (vaginal) [increased vaginal discharge].
  • Inspection and palpation of the abdomen (belly), inguinal region (groin region), etc. [colicky lower abdominal pain]
  • Palpation (bimanual; palpation with both hands) of the internal genital organs.
    • Cervix uteri (cervix) [cervicitis (inflammation of the cervix)]
    • Uterus (uterus) [Normal: anteflexed/angled forward, normal size, no tenderness] [Endometritis (endometritis)]
    • Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tubule (fallopian tube)) [Normal: free] [Adnexitis (inflammation of the fallopian tubes and ovaries); Salpingitis gonorrhoica (inflammation of the fallopian tubes)]
  • [possible sequelae:
    • Bartholinitis (inflammation of the Bartholin glands (vaginal auricular glands)).
    • Chronic adnexitis (inflammation of the fallopian tubes and ovary).
    • Sterility (infertility)
    • Tubargravidity (ectopic pregnancy).
    • Tuboovarian abscess (acute abscess around fallopian tube and ovary)]
  • [due topossible sequelae in the context of pregnancy:
    • Chorioamnionitis (infection of the amniotic cavity).
    • Premature birth
    • Umbilical infection
    • Premature rupture of membranes]
• Urological examination
  • Inspection and palpation of the genitals (penis and scrotum (scrotum); assessment of pubescence (pubic hair), penis (penile length: between 7-10 cm when flaccid; presence of: Indurations (tissue hardening), anomalies, phimosis/foreskin stenosis?) as well as testicular position and size (if necessary by orchimeter); if necessary, painfulness compared to the opposite side or where is the punctum maximum of pain) [due tosymptoms:
    • Male: balanitis (inflammation of the glans); urethritis (inflammation of the urethra) associated with pain on urination; mucopurulent urethral discharge; epididymitis (inflammation of the epididymis).
    • Woman: cervicitis (see above under gynecological examination), urethritis (inflammation of the urethra) associated with burning during urination and urethral discharge]Possible sequelae:
      • Epididymitis (inflammation of the epididymis).
      • Urethral stricture (narrowing of the urethral lumen) in men.
      • Penile edema (fluid accumulation in the penile tissue caused by local lymphangitis (inflammation of the lymph nodes)).
      • Periurethral abscess formation (formation of encapsulated pus accumulation in the area of the urethra).
      • Periurethral fistula formation (formation of ducts in the urethra area).
      • Periurethritis (inflammation of the tissue surrounding the urethra).
      • Prostatitis (inflammation of the prostate)
      • Vesiculitis (spermatocystitis) (seminal vesiculitis)]
  • Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation (assessment of the prostate in size, shape and consistency, detection of indurations (hardening of tissue) if necessary). [Prostatitis (prostatitis)]
• Cancer prevention
• If necessary, ophthalmological examination [due topossible secondary disease: amaurosis (blindness)].
• If necessary, neurological examination [due topossible secondary disease: meningitis (meningitis)]

In square brackets [ ] is referred to possible pathological (pathological) physical findings.