All patients should be tested for other possible STDs such as HIV etc. It is an aerobic bean shaped, gram negative diplococcus without a capsule that can cause disease only in humans. Male homosexuals are at risk for pharyngitis and proctitis. Persons with deficiency of complement C6-C9 are at risk for disseminated infections. The bacteria are very sensitive to cold and dry conditions, and is almost always transmitted through vaginal, oral, and anal sex.
Gonorrhea is usually symptomatic in men but often asymptomatic in women.
The mucosal surface is usually infected. Whether or not they the bacteria are piliated determines virulence. Piliated bacteria are virulent while the nonpiliated ones are avirulent. The bacteria use the pili to attach to the mucosal surface. They also produce an IgA protease that blocks IgA's action of disrupting cellular attachment.