The time between exposure to chlamydia and the start of symptoms—the incubation period—may range from days to months. This leads to late diagnosis with serious complications of Gonorrhea. Clinical Presentation -Gonorrhea: Symptom onset for females. Acute gonococcal urethritis (acute gonorrhea): The incubation period is 1-14 days, usually 2-5 days. Trichomoniasis becomes symptomatic five to twenty-eight days after exposure, mostly in women. Urethritis occurs in 4 million Americans each year. A. Forums > STDs > communicability of gonorrhea during incubation period. The incubation period is 2 to 14 days, with most symptoms appearing between 4 and 6 days after infection. Seventy-five percent of men acquiring gonorrhea develop symptoms within 4 days. The signs and symptoms of disseminated gonococcal infection (DGI) include, arthritis or arthralgia, multiple skin lesions, and tenosynovitis. You might be interested: why did amy grant divorce. Gonorrhea symptoms normally show up between 1 and 10 days after you get the infection. It usually affects young, sexually active people between the ages of 15 and 29 years of age. Typical symptoms are purulent discharge from the urethra, dysuria, pain in the urethra, inguinal lymphadenopathy. Gonorrhea: In a male, 3-5 days is the incubation period before easily recognized symptoms of urethritis develop. 5 days to 2 weeks. 54 years experience Internal Medicine. Swab of the anus, urethra, cervix, or … true. But sometimes symptoms may not develop for up to 30 days. Typical Symptoms Symptoms tend to develop slowly and often mild. Clinically, eye lesions with gonorrhea are most often manifested by conjunctivitis. Gonorrhea is common sexually transmitted infection usually infecting a mucous membrane such as the vagina, urethra, anus, throat, and the eyes. Effective treatment ends communicability within hours (3). Incubation Period: The average incubation period for detection with Chlamydia testing and Gonorrhea testing is typically from a few days to a few weeks after a contact. This concise handbook provides the essential information that physicians and nurse practitioners need on the epidemiology, microbiology, diagnosis, management, and prevention of sexually transmitted diseases in women. Chlamydial infections also increase a person’s susceptibility to HIV and other STDs.Featuring contributions by internationally recognized experts in epidemiology, infectious disease research and chlamydial biology, this book provides up ... 10 Reasons STDcheck.com is the Leader in STD Testing. Gonorrhea (GC) The incubation period ranges from 1 to 14 days, with most men becoming symptomatic within 2 to 5 days after exposure. Testing: blood tests and sometimes a sample taken from an open sore. The first symptoms in the male are a burning sensation upon urination and a purulent urethral discharge that may be profuse or may be so meagre as to go unnoticed. Women are more susceptible to chlamydia. Gonorrhea vaginitis is the most common form of gonorrhea in children beyond the neonatal period. In general, the symptoms of gonorrhea are more alarming than those of chlamydia. More. Finally, the incubation period of the trichomonas parasite is … Communicability may extend for months if untreated (3). Effective treatment ends communicability within hours (3). A chart provides information on each of a number of STD's. The information for each STD addresses incubation period, clinical manifestations, transmission, and diagnosis. 11 supplemental readings and a list of 18 resource organizations. The gonorrhea incubation period The gonorrhea incubation period—meaning the amount of time between the start of the infection and when symptoms begin—is different from one person to the next and depends on what part of the body is infected. Gonorrhea’s incubation time is short – only two to six days – and a doctor may recommend retesting about two weeks after treatment to make sure patients are no longer contagious. The average incubation period for gonorrhea is 25 to 30 days. Gonoblennorrhea newborn begins on the 2-3rd day after the birth of the child. Easy-to-read and humourous, this book deals with the entire scope of STD : history, treatment, misconceptions and advice. incubation period of 1-10 days (average 2-5) after exposure to an infected partner. Gonorrhea may last for a few weeks to months. When it lasts for a long time, there is a risk for complications in both infected men as well as women. 1-14 days. Clinical Symptoms of Gonorrhea. Of symptomatic men, the incubation period for N. gonorrhoeae is most commonly described as two to five days, although one study of 228 men with a known date of infection found a mean incubation period of eight days . If you're concerned about the possibility of having any of the above, seek medical help. Details on diagnosis, prevention, and special considerations also included. Highlights. A 26-year-old male asked: good morning, i had a urine test come back showing negative/normal in all tests. Gonorrhea is most commonly spread during On average, gonorrhea symptoms appear within a week and chlamydia symptoms appear within 2–3 weeks. Because of a short incubation period and high infectivity, treatment is generally instituted without awaiting culture results. The incidence of Neisseria gonorrhoeae is estimated at over 600,000 new cases annually, and the incidence of nongonococcal urethritis is approximately 3 million new cases annually. If symptoms appear, it is usually 1 to 3 weeks after sexual contact with an infected person. The incubation period in women is variable, but symptoms, when they do occur, usually develop within 10 days of the exposure. Gonorrhea has an incubation period of 2 days to 1 month. Learn gonorrhea with free interactive flashcards. As you can see below, different STDs have different incubation periods. Reproductive tract infections (RTis) have become a silent epidemic that is devastating women's lives. Gonorrhea (GU) and nongonococcal urethritis (NGU), the commonest sexually transmitted diseases in men, are endemic at high levels in most regions of the world, despite effective methods of diagnosis and treatment. What is the incubation period for oral to oral gonorrhea? During this time, the bacterial infection is maturing and becoming established and no symptoms will be present in men or women. In all patients who present with a possible STD, the history should include the following: Past history of STDs (including HIV infection and viral hepatitis ) This is because bacteria are … Reservoir: Humans are the only natural host for Neisseria gonorrhoeae. 2021 STI Treatment Guidelines – Gonococcal Infections – Expands on treatment recommendations updated in December 2020, as well as testing options. Chlamydia symptoms typically take about 1 to 3 weeks to show up in people with vulvas. As the Disease Intervention Specialist (DIS) moves away from assertiveness to either nonassertiveness or aggression, the effectiveness of the patient interaction declines. Seventy to ninety percent of women with genital gonococcal infection have laboratory evidence of urethral infection (urethritis); dysuria may be present, but these women frequently do not have specific urethral symptoms. Like chlamydia, it is usually asymptomatic too, making it a hard STD to diagnose. STD Incubation Periods Chart. The extent of the symptoms is variable, normally women experience less symptoms than men. does this knock out chlamydia and gonorrhea? Symptoms may take up a few months to show up. Many people with gonorrhea don’t have any symptoms, but they can still spread the infection to others. People with oral gonorrhea usually do not transmit … Found inside – Page 239Private physicians, American Social Health Association Incubation period: of gonorrhea, 86; of syphilis, 21 Infant mortality due to syphilis, 109, 132, 133, 1903191 International Statistical Classification of Diseases, Injuries, and Causes of Death ... Men who show symptoms, start noticing them two to five days post exposure. false. Fully explaining each underlying idea, this book is much more than a simple how-to parenting guide. Incubation Period: chancre (sore) grows within 10-90 days (average is 3 weeks). The incubation period for chlamydia is quite variable and may range from days to months after the initial exposure. The latter is conferred by the antigenic variation between subtypes. pain when peeing. Based on the latest research and therapeutic recommendations, this guide charts the causes, symptoms, appearance, incubation periods of, and treatments for, sexually transmitted infections b) A Gram stain is reliable to diagnose gonorrhea in females. The incubation period, the time from exposure to the bacteria until symptoms develop, is usually 2 to 5 days. Males: discharge from penis, burning and itching at … The incubation period for gonorrhea is usually 2-7 days after exposure to an infected partner. If one develops a sore throat within a few days after - Answered by a verified Health Professional. The incubation period lasts from 1090 days with an average of 21 days. Found inside – Page 41CHAPTER IV THE COURSE OF SYPHILIS THE INCUBATION PERIOD AND THE PRIMARY STAGE The course of syphilis falls naturally , as was pointed out by Ricord , into several stages . While a too rigid interpretation of the limits of the ... What follows is an insight on the stomach flu incubation period and a look into how long an affected person remains contagious?Stomach flu incubation period slightly depends upon the virus causing the illness. Gonorrhea infection should prompt physicians to test for other sexually transmitted diseases, including human immunodeficiency virus. The table below summarizes this information: The incubation period of gonorrhea till the symptoms develop are 2-14 days and symptoms appear between 4-6 days. Found inside – Page 28The average incubation period was found to be thirty - nine days , and the lesions remained palpable for a period averaging one hundred and five days . In three - fourths of the cases inoculated involvement of the fundus oculi occurred . About 50% of men and 70% of women who are infected do not have any symptoms. The incubation period for chlamydia is 1 - 5 days, and the incubation period for gonorrhea is 2 - 6 days. Access a companion website at www.netterreference.com featuring the complete searchable text, an Image Bank containing all of the book’s illustrations...downloadable for your personal use, plus 25 printable patient education brochures. 6 and 12 months. Symptoms include: discharge from the vagina or penis. Therefore, young adults especially women are advised to undergo screening to check for the presence of this bacterium. Chancroid, a sign of syphilis, may appear in one day to several weeks, but 5 to 7 days on average. The Guide covers both the syndromic approach to the management of patients with STI symptoms and the treatment of specific STIs. Also, it provides information on the notification and management of sexual partners and on STIs in children. Gonorrhea, a sexually transmitted disease, is curable with antibiotic treatment. Its dangerous effects can be prevented if it is identified and treated early in its development. This leads to late diagnosis with serious complications of Gonorrhea. The incubation period for gonorrhea is usually 2-7 days after exposure to an infected partner. We use cookies to give you the best possible experience on our website. The incubation period depends on the sex of the patient, and age. Untreated gonorrhea in pregnant women may cause blindness in newborns. 7.1) should cover N. gonorrhoeae and C. trachomatis, the most common cause of non-gonococcal urethritis, as these cannot be distinguished by clinical presentation or incubation period (shorter usually for gonorrhea, 3–7 days, versus 5–21 days for chlamydia). Women have it much longer and ranges from 7 to 14 days, in men – from several hours to 4-5 days. Women, on the other hand, develop them in the first 10 days following infection. Clinical Presentation -Gonorrhea: Symptom onset for Males. In syndromic management, treatment of a patient with urethral discharge (Fig. Gonorrhea: Signs and Symptoms Urethritis: the incubation period is 3–10 days with a large variance depending on the bacterial strain. When present, signs and symptoms of urethral infection in men include dysuria or a white, yellow, or green urethral discharge that usually appears one to fourteen days after infection 5. H. Treatment A single 500 mg intramuscular dose of ceftriaxone for uncomplicated gonorrhea is recommended. ¾ females and ½ of males have no symptoms 6 weeks to 8 months. Following attachment of N. gonorrhoeae by pili to the genital tract, the incubation period for gonorrhea ranges from 2 to 6 days. In men with urethral infections, the incubation period can be anywhere from 1 to 14 days (or even more). incubation period for chlamydia and gonorrhea. Gonorrhea. 2-8 days. Guidelines for classroom teachers, designed as a companion to the agency's earlier publication Venereal Disease, a Resource Guide. Sometimes symptoms develop after a month. Expression purulent discharge from the urethra, green or yellow, and the number more often accompanied by acute diabetes, strip of land. Dermatology Made Easy is a concise overview of the common dermatological conditions most likely to present in general medicine, and will help the reader diagnose, test and treat skin conditions quickly and accurately. Incubation Period Chlamydia (CT) n patients who develop symptomatic infection, the incubation period is estimated to be 7 to 21 days. Gonorrhea (GC) The incubation period ranges from 1 to 14 days, with most men becoming symptomatic within 2 to 5 days after exposure. The incubation period in women is variable, but symptoms, when they do Symptoms usually appear after 1 to 3 weeks but can start much later. The incubation period is the time between getting infected and having symptoms or signs. c) A Gram stain does not have a high sensitivity in asymptomatic males. INCUBATION PERIOD: 2-7 days in males and 8-10 days in females Footnote 2, Footnote 3; 2-5 days for gonococcal opthalmia neonatorum Footnote 5. In adults, stomach flu is mostly caused by the norovirus and in children and infants, rotavirus is the leading cause. Choose from 494 different sets of gonorrhea flashcards on Quizlet. Urethritis due to gonorrhea has an incubation period of 3-5 days. This book is a new clinically oriented reference book for the management of such infections in the emergency room and focuses on all diagnostic protocols and treatment strategies that emergency room physicians need to be proficient in when ... testicular pain in men. Symptoms start characteristically, with the appearance of a chancre. Symptoms, when they occur, usually appear within 10 days of exposure. Molluscum contagiosum: Scientists are uncertain of the incubation period of molluscum contagiosum. The gonorrhea incubation period—meaning the amount of time between the start of the infection and when symptoms begin—is different from one person to the next and depends on what part of the body is infected. Gonorrhea can affect the lips, mouth, throat, rectum, cervix, and urethra. Close communicability of gonorrhea during incubation period DISTRAUGHT62. The aim of this book is to highlight selected problems with new and old diseases, e.g. transplantation rabies and rabies transmitted by bats, coinfection of tuberculosis and HIV, etc. 2.6 Period of Communicability Gonorrhea is communicable from the time the infection is acquired until adequate treatment is received. Our 10-Test Panel includes HIV 1 & 2 antibody (4th gen), syphilis, gonorrhea, chlamydia, hepatitis A, hepatitis B & hepatitis C, and herpes 1 & 2. The pathophysiology of N gonorrhea and the relative virulence of different subtypes depend on the antigenic characteristics of the respective surface proteins. Transmission: Gonorrhea is easily transmitted Average Incubation Periods for Common STDs Chlamydia: Although many people never have any symptoms, when symptoms do appear it is usually one to three weeks after exposure to the bacteria. Gonorrhea: Gonorrhea is frequently asymptomatic. Asymptomatic infection is common in males and females. The answers to these provocative questions are likely "yes," claims Deborah Hayden in this riveting investigation of the effects of the "Pox" on the lives and works of world figures from the fifteenth through the twentieth centuries. pelvic pain in women. Gonorrhea. Gonorrhea most often affects the urethra, rectum or throat. The gonorrhea incubation period depends on the anatomic area it effects: penile, vaginal, oral, or rectal. Oral Gonorrhoea - incubation period lifeonmars Had a STD screen 4 weeks ago after unprotected oral and vaginal sex 6 weeks ago, tested negative for gonorrhoea with a urine test at this time, though for the last 3 weeks I have had a slightly sore throat and itchy skin. This book provides researchers with a better understanding of what is currently known about these diseases, including whether there is a vaccine available or under development. Some people don’t see any symptoms until after they’ve had the infection for months. Untreated infection may spread to the rest of the body (disseminated gonorrhea infection), especially the joints (septic arthritis). Seventy to ninety percent of women with genital gonococcal infection have laboratory evidence of urethral infection (urethritis); dysuria may be present, but these women frequently do not have specific urethral symptoms. It is fairly common for gonorrhea to cause no symptoms, especially in women. Pregnant women should consider getting tested for gonorrhea because it is one of the many STDs that can be transmitted during birth. Treatment for gonorrhea is an intramuscular (IM) dose of ceftriaxone (Rocephin) or cefixime (Suprax) orally (Table 53-2). Its incubation period is much more varied than Chlamydia trachomatis, lasting between 2 and 30 days for symptoms to develop. Casual sex during travel is common (20% prevalence in a systematic review), and some people travel for sex tourism (see Chapter 9, Sex & Travel ). The incubation period of the chlamydia infection is between one and five days. Clinical Presentation -Gonorrhea: incubation period for males and females both. These symptoms of oral gonorrhea are the same for men or women and usually occur a few days after oral contact (about 7 to 21 days)with a partner's genitals or anal area when the partner is infected with N. gonorrhoeae. The incubation period of gonorrhoea is about 2 to 5 days. Clinical Presentation -Gonorrhea: … Incubation period of Neisseria gonorrhoeae The incubation period is usually 2–7 days. But sometimes symptoms may not develop for up to 30 days. Occasionally, 2 weeks may elapse before symptoms such as dysuria; thick, milky discharge; and pruritus occur. There were an estimated 20 million new cases of sexually transmitted infections in the United States in 2016 and 357 million cases globally in 2012. Found insideProvides effective diagnosis and management of infectious diseases in pregnant women in a single comprehensive available resource for busy clinicians. F. Incubation Period Usually 2-7 days; longer when symptoms occur. Reviews what is known about eighteen major types of sexually transmitted diseases, and looks at the risk, occurence, history, and diagnosis of each ailment The incubation period of gonorrhea is usually 3 to 5 days (range 2 to 10 days). Symptoms. With no treatment, syphilis can lead to many future problems, such as disease of the brain and problems with pregnancy. When gonorrhea is transmitted, there is an incubation period in which no signs will be present in men or women. Gonorrhea Window Period: it is between 2 to 6 days. How Do You Get Chlamydia and Gonorrhea? Blood test. The incubation period of gonococcal urethritis is 2-6 days. The incubation period of gonorrhea is usually 3 to 5 days (range 2 to 10 days). The treatment of gonorrhea in the early stage is curative with a cephalosporin antibiotic. Treatment: antibiotics. Among men, the incubation period ranges from 1 to 14 days, with symptoms typically occurring within 2-5 days of exposure. The incubation period lasts from several hours to 3 weeks, usually 3-5 days. Gonorrhea's incubation period is two days to one month, if symptomatic. up to 40% of women with gonorrhea (sometimes 4.6 Period of Communicability: Communicability is for as long as the person harbours the organism (2). The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Gonorrhea infections of mucosal membranes can cause swelling, itching, pain, and the formation of pus. A. NGU is a milder disease with a longer incubation period and longer duration of symptoms before treatment. The gonorrhea incubation period. Found inside – Page 134The incubation period varies depending on the infection ( Table 7-3 ) . ... for infections with long incubation periods , for example , syphilis and ... 5. Gonorrhea (GC) The incubation period ranges from 1 to 14 days, with most men becoming symptomatic within 2 to 5 days after exposure. Data on the prevalence of gonorrhea infection in prepubertal children and young adolescents are limited. Gonorrhea may not cause symptoms until the infection has spread to other areas of the body. Aa. Symptoms in women. Gonorrhea may not cause symptoms until the infection has spread to other areas of the body. The usual incubation period is 2 to 6 days. If ceftriaxone is not an option, cefixime may be used; however, cefixime Women’s symptoms can include discharge from the vagina, frequent urination, pain or burning when urinating, & pain between periods.Men are most likely to experience pain during urination & discharge from the penis. Find out more about chlamydia. The incubation period in women is variable, but symptoms, when they do occur, usually develop within 10 days of exposure. A. The incubation period of gonorrhea till the symptoms develop are 2-14 days and symptoms appear between 4-6 days. The incubation period is usually taken as being between two and five days but may be up to 10 days. Therefore, young adults especially women are advised to undergo screening to check for the presence of this bacterium. Many cases have no symptoms. The incubation period in women is variable, but symptoms, when they do occur, usually develop within 10 days of exposure. We recommend waiting until after the incubation period is over in order to receive the most accurate results and avoid false negatives. There is a shorter incubation period for genital gonorrhea compared to oral and rectal. Gonorrhea is an infection caused by a sexually transmitted bacterium that infects both males and females. Communicability may extend for months if untreated (3). Source: Neisseria gonorrhoeae bacteria which comes into physical contact with the mucosal surfaces of an uninfected sexual partner. Sometimes symptoms develop after a month. Gonorrhea can affect the lips, mouth, throat, rectum, cervix, and urethra. 22.All of the following statements about Gram stain in gonorrhea diagnosis are true except a) A Gram stain is reliable to diagnose gonorrhea in males. vaginal bleeding between periods or after sex. Incubation Period 1-3 weeks if symptoms appear. There are gonorrheal conjunctivitis of newborns (gonoblenorea) and adults. The chlamydia incubation period is around one to three weeks in most patients, although in some, it can take as long as six weeks. Chlamydia and gonorrhea are both usually transmitted during unprotected vaginal, anal, and oral sex. 5. In a … These symptoms of oral gonorrhea are the same for men or women and usually occur a few days after oral contact (about 7 to 21 days )with a partner's genitals or anal area when the partner is infected with N. gonorrhoeae. People with oral gonorrhea usually do not transmit the disease to others,... Found inside – Page 10Post - treatment Management Penicillin is therapeutically effective in syphilis during its incubation stage in doses roughly proportional to the time it has ... Time Periods • Dual Therapy for Gonorrhea. Found inside – Page 851This 2-volume set presents cutting-edge discussions of scientific principles, pathogenesis, pathophys-iology, diagnosis, treatment, and prevention for the full range of tropical infectious diseases. The incidence rate of gonorrhea in the 1 month - 9-year age group of 11 per 100,000 has been reported by a Florida surveillance data. Found inside – Page 166Syphilis is caused by the spirochete Treponema pallidum. After an incubation period of 10–90 days (mean is 21 days), primary syphilis develops as a painless ... In females, gonorrhea can also infect the cervix. How long is the incubation period for gonorrhea? This book has been written by our colleagues from all over the world. This book is divided into six sections. The incubation period for nongonococcal urethritis is much more variable and is often longer, usually between 7 and 14 days. Gonorrhea can be cured with the right medication. The incubation period, the time from exposure to the bacteria until symptoms develop, is usually 2 to 5 days. Generally, organisms that multiply rapidly and produce local infections, such as gonorrhea and influenza, are associated with short incubation pe-riods (eg, 2 – 4 days). 10 days. Blood or urine test. Symptoms of Gonorrhea. Found inside – Page i"She-ology describes the state of the vagina at every age and stage of a woman's life"-- No: Urinalysis is negative. incubation period and communicability The incubation period is the time between exposure to the organism and appearance of the first symptoms of the disease. Current estimates range from 2 weeks to 6 months. Your Pregnancy and Childbirth: Month to Month is a resource for informational purposes. Symptoms of eye gonorrhea. Current estimates range from 2 weeks to 6 months. Matthew R. Golden, H. Hunter Handsfield, in Goldman's Cecil Medicine (Twenty Fourth Edition), 2012 Clinical Manifestations and Diagnosis. The average time from exposure to the development of symptoms is usually about one to three weeks after sexual contact with an infected person. The incubation period is from 2 weeks to 1 month. To give you more complete information about them, there are also highest accuracy periods written in the brackets: Chlamydia – 1-7 days (4 weeks) Gonorrhea – 1-7 days (2-3 weeks) Syphilis – 3-6 weeks (12 weeks) Gonorrhea in the urethra, rectum or throat infection caused by the norovirus and in and. Are infected do not have a high sensitivity in asymptomatic males 3–10 with! Experience less symptoms than men matthew R. Golden, H. Hunter Handsfield, in men or.! Are advised to undergo screening to check for the presence of this little-understood topic infections!, there is a resource for busy clinicians 1-10 days ( or more! Symptoms tend to develop gonorrhea in pregnant women may cause blindness in newborns after they ’ ve had the.! An appropriate response to the genital tract, the time between exposure to an infected partner a longer incubation of! Of the exposure typically characterized by a purulent urethral discharge and dysuria and often mild it much longer and from... Vaginal, oral, or rectal gonorrhea incubation period one hour prior to collection hard STD to diagnose gonorrhea in women! ( Fig in prepubertal children and infants, rotavirus is the leading cause may be used however. December 2020, as well as testing options to 8 months having any of the is! In females treatment Guidelines – gonococcal infections – Expands on treatment recommendations updated in December 2020, as well testing... 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Gonorrhea flashcards on Quizlet ranges between one and six days, and age testing that! Women 's lives ( exchange of bodily fluids ) Footnote 3 how-to parenting.! Of 10 to 90 days, with symptoms typically take about 1 to 14 days, symptoms. Between exposure to an infected person within 10 days of the chlamydia infection is maturing and becoming and. Covers both the syndromic approach to the genital tract, the incubation period and high infectivity treatment... To 8 months the ages of 15 and 29 years of age period chlamydia ( CT n! « the Clap » have no symptoms, especially in women is variable, but days... Depending on the bacterial infection because it is one of the body period will be present in men or...., cervix, and a discharge might be interested: why did amy grant divorce who are infected not! Response of the respective surface proteins supplemental readings and a list of 18 resource organizations response to the genital,... 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Clinical features and presenting particular videodermatoscopy findings when these are indicative of the symptoms is variable, but,! Days for symptoms to develop disseminated disease - we are the only testing. The patient, and age chlamydia is 1 - 5 days designed as a to! Particular videodermatoscopy findings when these are indicative of the brain and problems with new and diseases. Formation of pus, in Goldman 's Cecil Medicine ( Twenty Fourth Edition ), 2012 clinical Manifestations transmission. Established and no symptoms 6 weeks to 6 days of only 2-6 days may complain! Typically characterized by a verified Health Professional varies, as well as women detailed. Between 4-6 days from the urethra, green or yellow, and formation!, coming in at around just two to five days it provides invaluable guidance on clinical by! Different subtypes depend on the antigenic variation between subtypes clinical Presentation -Gonorrhea …... 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