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Gonorrhea vs Chlamydia

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

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  1. fly1346

    fly1346 7+ Year Member

    May 17, 2007
    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

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  3. CherryRedDracul

    CherryRedDracul 2 Chainz Muscular Dystrophy 2+ Year Member

    Oct 12, 2012
    North America
    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.
    dyspareunia, BlueArc and J DUB like this.
  4. J ROD

    J ROD Watch my TAN walk!! Lifetime Donor 10+ Year Member

    Aug 1, 2005
    working on my tan......
    Rocket Scientist
    Good description. Not much I can add.
  5. Venko

    Venko True to self Lifetime Donor 10+ Year Member

    Jan 24, 2006
    Rochester, MN
    Gonorrhea also can cause a monoarthritis without any urinary symptoms.
  6. dyspareunia


    Mar 6, 2014
    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.
    BlueArc likes this.
  7. CherryRedDracul

    CherryRedDracul 2 Chainz Muscular Dystrophy 2+ Year Member

    Oct 12, 2012
    North America
    Makes sense. Thanks for pointing that out.
  8. Enzymes

    Enzymes 2+ Year Member

    Mar 13, 2012
    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.
    BlueArc likes this.

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