{"id":2190,"date":"2021-01-22T08:00:00","date_gmt":"2021-01-22T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=2190"},"modified":"2026-08-27T20:11:02","modified_gmt":"2026-08-27T13:11:02","slug":"%e6%b7%8b%e7%97%85%e6%84%9f%e6%9f%93%e6%88%91%e6%84%9f%e6%9f%93%e4%ba%86","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/zh\/2021\/01\/22\/gonorrhea-infection-am-i-infected\/","title":{"rendered":"\u6dcb\u75c5\uff1a\u75c7\u72b6\u3001\u68c0\u6d4b\u4e0e\u6cbb\u7597"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-e269d6e6 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/zh\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" 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onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"has-drop-cap wp-block-paragraph\">Gonorrhoea is among the commonest reasons men come to a urology clinic worried. The typical presentation is a thick, pus-like discharge from the urethra with burning on passing urine, usually within a week or two of exposure. It is caused by the bacterium <em>Neisseria gonorrhoeae<\/em>, and it is curable \u2014 but three things about it are frequently got wrong, and each of them matters.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1200\" height=\"800\" data-attachment-id=\"2197\" data-permalink=\"https:\/\/drsoaraweeurology.com\/zh\/2021\/01\/22\/gonorrhea-infection-am-i-infected\/emotive-depressed-young-embarrassed-man-bites-fingernails-in-panic-looks-with-nervous-expression-going-to-cry-with-worried-look-recieves-negative-awful-news-poses-against-white-background\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Terrified-male.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;6.3&quot;,&quot;camera&quot;:&quot;Canon EOS 5DS R&quot;,&quot;caption&quot;:&quot;Emotive depressed young embarrassed man bites fingernails in panic, looks with nervous expression, going to cry with worried look, recieves negative awful news, poses against white background.&quot;,&quot;created_timestamp&quot;:&quot;1511798120&quot;,&quot;focal_length&quot;:&quot;70&quot;,&quot;iso&quot;:&quot;100&quot;,&quot;shutter_speed&quot;:&quot;0.00625&quot;,&quot;title&quot;:&quot;Emotive depressed young embarrassed man bites fingernails in panic, looks with nervous expression, going to cry with worried look, recieves negative awful news, poses against white background.&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"A nightmare for Gentlemen is, more than 50% of female will never manifest any symptoms.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;A nightmare for Gentlemen is, more than 50% of female will never manifest any symptoms.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Terrified-male.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Terrified-male.jpg?resize=800%2C533&amp;ssl=1\" alt=\"Man worried about symptoms of a sexually transmitted infection after a risky encounter\" class=\"wp-image-2197\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Terrified-male.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Terrified-male.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Terrified-male.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Terrified-male.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Terrified-male.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">The difficult part for couples: most infected women never develop any symptoms at all.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">How it presents<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In <strong>men<\/strong>, urethral infection usually announces itself \u2014 discharge and burning within days of exposure. Not always, though: a proportion of urethral infections cause little or nothing, and the older figure of over 90% symptomatic overstates how reliably it declares itself.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In <strong>women<\/strong>, more than half never develop symptoms, and when they do \u2014 discharge, burning, pelvic pain \u2014 they are easily attributed to something else. This asymmetry is why gonorrhoea spreads so effectively, and why <strong>a man diagnosed with it must tell his partner regardless of whether she feels unwell<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The sites a urine test does not check<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">This was missing from the earlier version and is the most practically useful thing on the page.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Gonorrhoea also infects the <strong>throat<\/strong> and the <strong>rectum<\/strong>, and at those sites it is usually completely silent. <strong>A urine sample tests the urethra and nothing else.<\/strong> Someone who has had oral or receptive anal sex and receives a negative urine result has been reassured about one site out of three \u2014 and can go on transmitting from an untreated one, or be re-infected from it.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The remedy is simple: <strong>say what kind of exposure you have had<\/strong>, so that throat and rectal swabs are taken where relevant. It is an awkward conversation that takes ten seconds and changes what gets tested.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1200\" height=\"675\" data-attachment-id=\"2194\" data-permalink=\"https:\/\/drsoaraweeurology.com\/zh\/2021\/01\/22\/gonorrhea-infection-am-i-infected\/gay\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Gay.jpg?fit=1200%2C675&amp;ssl=1\" data-orig-size=\"1200,675\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;2.8&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark IV&quot;,&quot;created_timestamp&quot;:&quot;1467518526&quot;,&quot;focal_length&quot;:&quot;45&quot;,&quot;iso&quot;:&quot;125&quot;,&quot;shutter_speed&quot;:&quot;0.003125&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Gonorrhea infection is reported more in men whom having sex with men.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Gonorrhea infection is reported more in men whom having sex with men.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Gay.jpg?fit=800%2C450&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Gay.jpg?resize=800%2C450&amp;ssl=1\" alt=\"Couple, illustrating that testing needs to cover throat and rectal sites as well as urine depending on exposure\" class=\"wp-image-2194\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Gay.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Gay.jpg?resize=300%2C169&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Gay.jpg?resize=1024%2C576&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Gay.jpg?resize=768%2C432&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Gay.jpg?resize=16%2C9&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Which samples are taken depends on the kind of exposure \u2014 a urine test alone checks only the urethra.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Testing is not optional<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">An earlier version of this article said that gonorrhoea is primarily a clinical diagnosis and that confirmatory testing is optional in many cases. <strong>That no longer reflects good practice and has been corrected.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Discharge and burning are not specific to gonorrhoea \u2014 chlamydia, <em>Mycoplasma genitalium<\/em> and trichomonas produce the same picture and are treated differently. Beyond getting the treatment right, testing matters for three further reasons: it makes partner notification possible on solid ground rather than suspicion; it allows a culture to be taken where treatment fails, which is how resistance is detected; and it prompts testing for the infections that travel alongside it, <strong>including HIV and syphilis<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/drsoaraweeurology.com\/2020\/05\/28\/stis-std-pcr-urine-test\/\">nucleic acid amplification test<\/a> is highly accurate on a first-catch urine sample, and the same technology is used on throat and rectal swabs. See also <a href=\"https:\/\/drsoaraweeurology.com\/2021\/10\/15\/gonorrhea-infection-guideline\/\">the treatment guideline in more detail<\/a> and <a href=\"https:\/\/drsoaraweeurology.com\/2021\/10\/08\/syphilis-correct-way-deal-with\/\">syphilis<\/a>.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1200\" height=\"800\" data-attachment-id=\"2198\" data-permalink=\"https:\/\/drsoaraweeurology.com\/zh\/2021\/01\/22\/gonorrhea-infection-am-i-infected\/urine-analysis-in-the-laboratory-medical-urine-test-urine-sample-for-laboratory-analysis\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Urine-test.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;5&quot;,&quot;credit&quot;:&quot;Giovanni Cancemi&quot;,&quot;camera&quot;:&quot;NIKON D5200&quot;,&quot;caption&quot;:&quot;Urine analysis in the laboratory. Medical urine test. Urine sample for laboratory analysis.&quot;,&quot;created_timestamp&quot;:&quot;1572876476&quot;,&quot;focal_length&quot;:&quot;40&quot;,&quot;iso&quot;:&quot;100&quot;,&quot;shutter_speed&quot;:&quot;0.033333333333333&quot;,&quot;title&quot;:&quot;Urine analysis in the laboratory. Medical urine test. Urine sample for laboratory analysis.&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Latest technology on special urine test is reported more than 95% detection rate.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Latest technology on special urine test is reported more than 95% detection rate.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Urine-test.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Urine-test.jpg?resize=800%2C533&amp;ssl=1\" alt=\"First-catch urine sample used for nucleic acid amplification testing for gonorrhoea\" class=\"wp-image-2198\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Urine-test.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Urine-test.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Urine-test.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Urine-test.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/Urine-test.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Urine-based NAAT is highly accurate \u2014 for the urethra. Other sites need their own swabs.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Treatment, and why it has changed<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The mainstay is a <strong>single intramuscular antibiotic injection<\/strong>. An oral antibiotic is added <strong>when chlamydia has not been excluded<\/strong> \u2014 which is a change from the older approach of giving both to everyone as a matter of routine, and the earlier version of this article described that older approach. Where testing has shown chlamydia is not present, the second drug is not needed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Partners must be treated at the same time<\/strong>, whether or not they have symptoms, or the infection simply travels back and forth. This is not optional and it is the step most often skipped.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The resistance problem<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Also absent from the earlier version, and the reason none of the above should be done casually.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Neisseria gonorrhoeae<\/em> has developed resistance to every class of antibiotic used against it in turn, and the World Health Organization lists it among the organisms of greatest concern. The current injection works; the margin is narrower than it was. Three consequences follow for anyone being treated:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Take the treatment given, in full<\/strong>, rather than a leftover antibiotic from a friend or a pharmacy purchase \u2014 partial treatment is exactly how resistant strains are selected.<\/li>\n\n\n\n<li><strong>Go back if symptoms persist after treatment<\/strong>, rather than assuming it needs longer. Persistent symptoms need a culture, which is what identifies a resistant strain.<\/li>\n\n\n\n<li><strong>Throat infection is harder to clear<\/strong> than urethral infection, and is one situation where a repeat test after treatment is appropriate.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1200\" height=\"800\" data-attachment-id=\"2196\" data-permalink=\"https:\/\/drsoaraweeurology.com\/zh\/2021\/01\/22\/gonorrhea-infection-am-i-infected\/close-up-picture-of-docters-hands-holding-hypodermic-syringe\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/IM-injection.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;7.1&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark III&quot;,&quot;caption&quot;:&quot;close up picture of doctor&#039;s hands holding hypodermic syringe&quot;,&quot;created_timestamp&quot;:&quot;1599413221&quot;,&quot;focal_length&quot;:&quot;160&quot;,&quot;iso&quot;:&quot;160&quot;,&quot;shutter_speed&quot;:&quot;0.01&quot;,&quot;title&quot;:&quot;close up picture of docter&#039;s  hands holding hypodermic syringe&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Intramuscular antibiotic injection is recommended when Gonorrhea infection has been diagnosed.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Intramuscular antibiotic injection is recommended when Gonorrhea infection has been diagnosed.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/IM-injection.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/IM-injection.jpg?resize=800%2C533&amp;ssl=1\" alt=\"Intramuscular antibiotic injection, the mainstay of gonorrhoea treatment\" class=\"wp-image-2196\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/IM-injection.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/IM-injection.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/IM-injection.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/IM-injection.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/01\/IM-injection.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">A single injection remains the mainstay \u2014 and resistance has narrowed the options behind it.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">After treatment<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Abstain from sex for at least a week<\/strong> after treatment, and until partners have been treated too.<\/li>\n\n\n\n<li><strong>Get tested for HIV and syphilis<\/strong> at the same time, and remember that some of these need repeating after a window period.<\/li>\n\n\n\n<li><strong>Consider a repeat test around three months later.<\/strong> Reinfection is common \u2014 commoner than treatment failure \u2014 and it is usually silent in the partner who passed it back.<\/li>\n\n\n\n<li><strong>Use condoms with new or casual partners.<\/strong> Gonorrhoea and HIV travel in the same populations and gonorrhoea inflammation makes HIV easier to acquire, which is the real reason the two are linked rather than any single statistic.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Symptoms that need attention the same day<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Testicular pain and swelling<\/strong> \u2014 the infection has reached the epididymis. Sudden severe testicular pain is an emergency in its own right and is treated as <a href=\"https:\/\/drsoaraweeurology.com\/2021\/02\/19\/testicular-torsion-urologic-emer\/\">torsion<\/a> until proved otherwise.<\/li>\n\n\n\n<li><strong>Fever with painful, swollen joints or a rash<\/strong> \u2014 uncommon, but it means the infection has entered the bloodstream and needs hospital treatment.<\/li>\n\n\n\n<li><strong>A red, painful, discharging eye<\/strong> after any genital infection \u2014 this can threaten sight and is urgent.<\/li>\n\n\n\n<li><strong>Severe lower abdominal or pelvic pain in a female partner<\/strong>, with or without fever.<\/li>\n\n\n\n<li><strong>Inability to pass urine.<\/strong><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Gonorrhoea<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">What are the symptoms in men?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Typically a thick pus-like discharge from the urethra with burning on passing urine, within days of exposure. Testicular pain or swelling suggests the infection has spread and needs prompt assessment. A proportion of urethral infections cause few or no symptoms, so absence of discharge does not exclude it.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Can women have gonorrhoea without symptoms?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Yes \u2014 more than half never develop noticeable symptoms, and when they do, they are easily mistaken for something else. This is why a man diagnosed with gonorrhoea must tell his partner regardless of how she feels, and why she needs treating rather than testing alone.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">My urine test was negative. Am I clear?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">For the urethra, yes. A urine sample does not test the throat or the rectum, where gonorrhoea is usually silent. If you have had oral or receptive anal sex, those sites need their own swabs \u2014 tell whoever is testing you what kind of exposure you have had.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Do I really need a test, or can it be treated on symptoms?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Test. Chlamydia, <em>Mycoplasma genitalium<\/em> and trichomonas cause the same symptoms and are treated differently. Testing also underpins partner notification, allows a culture if treatment fails \u2014 which is how resistance is found \u2014 and prompts screening for HIV and syphilis. An earlier version of this article described confirmatory testing as optional, which has been corrected.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How is it treated?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">A single intramuscular antibiotic injection is the mainstay, with an oral antibiotic added when chlamydia has not been excluded \u2014 rather than routinely giving both, which was the older approach. Partners are treated at the same time whether or not they have symptoms.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">My symptoms have not settled after treatment. What now?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Go back rather than waiting or taking more antibiotics on your own. Persistent symptoms need a culture, which is how a resistant strain is identified \u2014 and they may equally represent reinfection from an untreated partner, which is commoner than treatment failure.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What happens if it is left untreated?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">In men, epididymitis and, rarely, urethral scarring. In women, pelvic inflammatory disease, chronic pelvic pain, infertility and ectopic pregnancy. Rarely the infection enters the bloodstream, causing fever, joint pain and rash. Untreated gonorrhoea also makes HIV easier to acquire and to transmit.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Arranging a consultation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dr. Soarawee Weerasopone sees patients confidentially at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Bangkok Hospital Headquarters<\/a> and at Samitivej Sriracha Hospital in Chonburi on <a href=\"tel:0880221445\">088-022-1445<\/a>. Bring any test results you already have, and be ready to say what kind of exposure occurred and when \u2014 it determines which samples are taken.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/01\/22\/gonorrhea-infection-am-i-infected\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2021\/01\/22\/gonorrhea-infection-am-i-infected\/\",\n      \"name\": \"Gonorrhoea: Symptoms, Testing and Treatment\",\n      \"description\": \"Gonorrhoea presentation in men and women, why laboratory confirmation is required rather than optional, why urine testing misses pharyngeal and rectal infection, and the implications of antimicrobial resistance.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2021-01-22\",\n      \"dateModified\": \"2026-08-27\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/01\/22\/gonorrhea-infection-am-i-infected\/#gonorrhoea\" },\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"disambiguatingDescription\": \"Several corrections were made. The article stated that gonorrhoea is primarily a clinical diagnosis and that confirmatory testing is optional in many cases; laboratory confirmation is required, since chlamydia, Mycoplasma genitalium and trichomonas present identically and are treated differently, and testing underpins partner notification, culture where treatment fails, and concurrent HIV and syphilis screening. Dual therapy was described as routine because of chlamydia co-infection; current practice is a single intramuscular injection with an oral agent added only where chlamydia has not been excluded. Pharyngeal and rectal infection, which are usually asymptomatic and are not detected by a urine sample, were absent and are now given their own section. Antimicrobial resistance was absent entirely. The figure that over 90 percent of infected men are symptomatic has been softened. 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Culture with susceptibility testing is indicated where treatment fails.\"\n      },\n      \"possibleComplication\": \"Epididymitis and urethral stricture in men; pelvic inflammatory disease, chronic pelvic pain, infertility and ectopic pregnancy in women; disseminated gonococcal infection with fever, arthritis and rash; gonococcal conjunctivitis; and increased susceptibility to HIV acquisition and transmission.\",\n      \"possibleTreatment\": {\n        \"@type\": \"MedicalTherapy\",\n        \"name\": \"Single intramuscular antibiotic injection, with an oral agent added where chlamydial co-infection has not been excluded. Concurrent treatment of sexual partners regardless of symptoms. Test of cure is appropriate for pharyngeal infection, and persistent symptoms after treatment require culture rather than empirical re-treatment.\"\n      }\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/01\/22\/gonorrhea-infection-am-i-infected\/#faq\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/01\/22\/gonorrhea-infection-am-i-infected\/#webpage\" },\n      \"mainEntity\": [\n        {\n          \"@type\": \"Question\",\n          \"name\": \"My urine test for gonorrhoea was negative. Am I clear?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"For the urethra, yes. A urine sample does not test the throat or rectum, where gonorrhoea is usually silent. If you have had oral or receptive anal sex, those sites need their own swabs, so tell whoever is testing you what kind of exposure occurred.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Do I need a test, or can gonorrhoea be treated on symptoms alone?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Testing is required. Chlamydia, Mycoplasma genitalium and trichomonas cause the same symptoms and are treated differently. Testing also underpins partner notification, allows culture if treatment fails, and prompts HIV and syphilis screening.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"How is gonorrhoea treated?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"A single intramuscular antibiotic injection is the mainstay, with an oral antibiotic added when chlamydia has not been excluded rather than routinely. Partners are treated at the same time whether or not they have symptoms.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"My symptoms have not settled after gonorrhoea treatment. What should I do?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Return for assessment rather than taking further antibiotics independently. Persistent symptoms require culture, which identifies resistant strains, and may equally represent reinfection from an untreated partner, which is commoner than treatment failure.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>\u5192\u9669\u884c\u4e3a\u540e\u7684\u70e7\u707c\u611f\u548c\u6392\u6cc4\u7269\u2014\u2014\u4ee5\u53ca\u4eba\u4eec\u5ffd\u7565\u7684\u90e8\u5206\uff1a\u5c3f\u68c0\u5e76\u4e0d\u80fd\u68c0\u67e5\u54bd\u5589\u6216\u76f4\u80a0\uff0c\u5927\u591a\u6570\u611f\u67d3\u5973\u6027\u6839\u672c\u6ca1\u6709\u4efb\u4f55\u75c7\u72b6\uff0c\u800c\u4e14\u73b0\u5728\u8fd9\u79cd\u75c5\u539f\u4f53\u5df2\u7ecf\u5177\u6709\u6297\u836f\u6027\uff0c\u56e0\u6b64\u9700\u8981\u8fdb\u884c\u68c0\u6d4b\uff0c\u800c\u4e0d\u662f\u7b80\u5355\u5730\u8ba4\u4e3a\u5176\u4e0d\u5b58\u5728\u3002.<\/p>","protected":false},"author":185281453,"featured_media":10050,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"How gonorrhoea presents in men and women, why testing is required rather than optional, why a urine sample misses throat and rectal infection, and what antibiotic resistance means for treatment.","jetpack_seo_html_title":"Gonorrhoea: Symptoms, Testing & Treatment | Dr. Soarawee Bangkok","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1365],"tags":[1422,1421],"class_list":["post-2190","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sexual-transmitted-diseases","tag-chlamydia","tag-gonorrhea"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-zk","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/Gonorrhea-Symptoms.webp?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/posts\/2190","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/comments?post=2190"}],"version-history":[{"count":30,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/posts\/2190\/revisions"}],"predecessor-version":[{"id":11744,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/posts\/2190\/revisions\/11744"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/media\/10050"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/media?parent=2190"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/categories?post=2190"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/zh\/wp-json\/wp\/v2\/tags?post=2190"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}