- [Voiceover] Of the many sexually transmitted infections,
or STIs, gonorrhea is the second most common.
The most common STI is chlamydia.
Chlamydia, and we'll talk more about chlamydia later.
Right now, let's focus on gonorrhea and why
these two happen together.
These two diseases often occur together
for two reasons.
First, they have similar risk factors,
which include things like having multiple
sexual partners and/or having frequent
unprotected sex.
The other reason is that infection with one of these bugs
makes your body susceptible to a second infection
by dampening the immune system.
So I promise we'll go into more detail
about chlamydia later, but for now let's talk more
about gonorrhea.
It's caused by a bug referred to as neisseria gonorrhoeae,
and the reason why we call gonorrhea a sexually transmitted
infection is because it undergoes this process
referred to as transmission
where it moves from one person to another
by several mechanisms.
Most commonly, gonorrhea will be transmitted through sex,
which can include oral sex, vaginal sex, or even anal sex.
Another important mechanism of transmission includes
childbirth and we'll talk more about the outcomes of that
in a minute, so these are the main ways that
gonorrhea can be transmitted.
Let's move this off to the side and let's focus instead
on my poor friend over here who's going to have
all the different signs and symptoms a person can get
with gonorrhea.
Now because we said the main way gonorrhea spreads
from one person to the other is by sex,
let's start by focusing on signs and symptoms
at our sexual organs.
So here you can see on the left I have female genitalia
drawn out and on the right side,
we have male genitalia drawn here.
If we were to imagine our gonorrhea infection,
so I'll use this as sort of a way to mimic gonorrhea
as it spreads, perhaps you can have a female
infecting a male with gonorrhea and so,
because the penis is used during sex,
that can actually seed or spread up the urethra.
This yellow line here, that is your urethra.
We'll go into this in more detail in another video
but the gonorrhea bacteria will latch on to the walls
in your urethra.
Your urethra is lined by epithelial cells,
and so this bacterium will enter those cells.
That will trigger an immune response.
Your white blood cells will detect that something is wrong
and they'll come up to the urethra through the blood stream
to attack wherever the gonorrhea has spread.
So if the gonorrhea has only entered a single
epithelial cell in your urethra, it'll cause that cell
to die in a process that's referred to as apoptosis.
Maybe you've heard of it.
It's where the body specifically decides to kill a cell
because it's doing something wrong or it's been infected
like in this case.
Now in the ideal world, the white blood cell will kill off
this one epithelial cell in the urethra that's been infected
and we'd be done with the infection,
but often times there are multiple organisms
that kind of spread along the urethral tract,
which cause more white blood cells to come from
the blood stream to attack the bacteria or the cells
that are infected and as a result you get inflammation.
Inflammation of the urethra
causing things like pain when you urinate,
maybe some burning that's there as well,
and general discomfort.
Because of the bacterium, your urethra will cause you
a lot of pain and you've got
what's referred to as urethritis.
If the gonorrhea spreads up here to your prostate,
this pink thing is your prostate, you can get what's called
prostatitis, and this inflammatory process that's occurring
along the way causes white blood cells that may die
and epithelial cells that will also go undergo apoptosis
with some of the gonorrheal bacteria to sluff off
and fall through and come out from the urethral meatus
or the end of the penis.
And you can actually see pus coming out of the penis.
Now just like the epithelial cells within your urethra,
gonorrhea can also effect the epithelial cells
that line the anus or even higher up here
in the rectum.
As a result, you might not see pus coming out from the anus,
and instead you might see infections of the cells
that line the anus or of the anus.
So this skin infection you'd see here
are referred to as pustules. Pustules.
Again, that's from the gonorrheal bacteria infecting
the epithelial cells of the anus.
You can also have pustules occur in the female,
so let's label that right here as well as urethritis,
but because of the difference in anatomy
between the male and the female,
you may also see an infection of the vagina,
or vaginitis.
More commonly though, infected women will have pain
during sex because of pressure that's put on the cervix
due to the gonorrhea that's spread there
causing cervicitis. Cervicitis.
Gonorrhea can spread even further up from the cervix
through the uterus and actually come out
the fallopian tubes to cause an infection
within the pelvic cavity, which is why it's called pelvic
inflammatory disease.
Pelvic inflammatory disease, or PID.
Now from the genital tract, gonorrhea can spread
into the blood stream and go elsewhere
in the body and quite classically,
it goes to your joints like the knee over here
to cause arthritis by infecting the joint capsule,
so down below here you can see the joint capsule.
Here's bone, here's articular cartilage,
and this is sonovial fluid or just some fluid
in between the two bones in the joint.
So if gonorrhea spreads here,
think about what else is gonna come right after it.
White blood cells.
Remember, they're going to come chasing
after the gonorrhea and they're going to cause
inflammation and if you notice in this picture,
there's not a lot of space between the two sets
of articular cartilage and the bones here.
If too many white blood cells get into the sonovial cavity,
and cause inflammation, you're going to have
a more difficult time using that joint
which leads to pain in the knee and difficulty walking.
Left untreated, gonorrhea can also spread
to the central nervous system.
Gonorrhea can infect the lining around the brain
and the spinal cord.
This lining is referred to as the meninges; the meninges.
An infection of the meninges is referred to as meningitis.
Menigitis.
Unfortunately, gonorrheal menigitis is more common
in children than it is adults.
Speaking of children, I mentioned earlier
that you can spread gonorrhea through childbirth.
An infected mother can spread the infection
if undetected to her child and very early on,
you would know if a child is infected with gonorrhea
if they look like this.
You'll notice that the baby
may have this very signature crusting of the eyes
that's referred to as gonococcal opthalmia,
which is just to say that you have an opthalmic
or an eye infection of gonorrhea.
This baby can also have a variety of other issues related
to the gonorrhea, such as menigitis, as we talked about
or even pneumonia, which is why neisseria gonorrhoeae
or gonococcus as one of the bugs pregnant women
are often screened for and treated for
before they give birth to decrease the odds
of this sort of thing happening.