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. It s just because the anorectal opening is relatively adjacent to the vaginal opening. They present with lower abdominal pain, they may report pain during sexual intercourse and they may report abnormal menses or bleeding. On exam, they have tenderness in the lower abdomen. This is a Gram negative intracellular diplococcus and a group of polymorphonuclear leukocytes and that is what you are looking for on Gram stain.