Stress that oral or anal sex also can transmit disease. PID generally is the most feared complication of gonococcal infection because it is one of the leading causes of female infertility and often leads to hospitalization. This can be devastating to any woman, especially an adolescent who potentially has many years of childbearing ahead of her. Epididymitis and orchitis occur infrequently in males who go untreated. These conditions usually respond well to the same antibiotics used for uncomplicated urethritis but administered for a longer course.
Gonorrhea is the most common cause of arthritis in the adolescent.
Adequate diagnosis may require culturing extraarticular sites for N gonorrhoeae. Disseminated gonococcal infection is an acute illness that causes fever, asymmetric polyarthralgias, and skin pustules overlying small joints in patients with gonorrhea. The prognosis for patients with gonorrhea is excellent if the diagnosis is made and treatment is started before progression or complications occur. This often leads to inadequate treatment for a presumed urinary tract infection. As a result, fertility may be impaired permanently.