There is a very significant incidence of asymptomatic infection in women but this does not happen very often at all in men. But if you re not thinking about it in a sexually active woman, especially if you don t take a history and find out her risk factors, you may miss the asymptomatic infection and she may become symptomatic later resulting in ectopic pregnancy or infertility. If you remember one thing from this part of the lecture, I want you to remember that coinfection with Chlamydia trachomatis is extremely common in both men and women who have gonorrhea and that s why we recommend epidemiologic treatment of everyone with gonorrhea with an agent that is effective for chlamydia. So whenever you diagnose gonorrhea, you should always treat the patient for chlamydia as well. I will just make one more comment.
Adolescents are high risk.
Asymptomatic infections are more common in women and chlamydia is a very common coinfection. I m going to move on to clinical manifestations of gonorrhea. In males, acute anterior urethritis is the most common manifestation. Incubation period is usually a few days and usually there is a very copious purulent discharge. In females, cervicitis is the most common manifestation and the incubation period is much more variable for women.