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Gonorrhea vs Chlamydia

Discussion in 'Step I' started by fly1346, May 15, 2014.

  1. fly1346

    fly1346 7+ Year Member

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    I keep getting questions on either one, and always get confused, between the 2. Can someone please explain, the key differences between the 2 along with the treatment. Mainly, how do they present clinically..

    Much appreciated

    Thanks
     
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  3. CherryRedDracul

    CherryRedDracul Resident Sh!tposter Physician 5+ Year Member

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    Both can cause urethritis and the feared complication, pelvic inflammatory disease. Urethritis, but not cystitis, will give you discharge.

    N. gonorrhea: Gram - diplococci.
    C. trachomatis: you might see a bunch of neutrophils, but no organisms. That's because Chlamydia are obligate intracellular organisms.

    For treatment, a 3rd generation cephalosporin like ceftriaxone does the trick for Neisseria species. You can treat Chlamydia with either a macrolide like azithromycin or a tetracycline like doxycycline. But you don't want to give doxy to a pregnant patient. Often, you'll treat patients with both antibiotics because co-infection is so common.
     
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  4. J ROD

    J ROD Watch my TAN walk!! Rocket Scientist Physician Pharmacist Lifetime Donor Classifieds Approved 10+ Year Member

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    Good description. Not much I can add.
     
  5. Venko

    Venko True to self Physician Lifetime Donor Classifieds Approved 10+ Year Member

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    Gonorrhea also can cause a monoarthritis without any urinary symptoms.
     
  6. dyspareunia

    dyspareunia

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    CT is more common than GC.

    GC = thick, purulent discharge.
    CT = watery, cloudy discharge.

    Prophylactic erythromycin ointment prevents GC neonatal conjunctivitis, but doesn't work for CT.

    I think CT doesn't show on gram stain because it lacks muramic acid, not because it is obligate intracellular. You will see gram neg diplococci inside PMNs in the case of GC.. hence you can see intracellulars on gram stain.
     
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  7. CherryRedDracul

    CherryRedDracul Resident Sh!tposter Physician 5+ Year Member

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    Makes sense. Thanks for pointing that out.
     
  8. Enzymes

    Enzymes 2+ Year Member

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    Yes, good discussion guys. I also really like the point about the difference in discharges. Sometimes that is your only clue. It is much thicker with Neisseria.
     
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