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Michael Shirazi M.D.


Michael Shirazi MD offers accurate Gonorrhea testing and treatment in his 2 private medical offices.

What is Gonorrhea?

Gonorrhea is a sexually transmitted infection. Gonorrhea is a very common STD in NY. It is caused by the bacterium Neisseria gonorrhea. In 2002, the rate of reported gonorrheal infections in the U.S. was 125 per 100,000 persons. Gonorrhea testing is essential for the following reasons: Many cases are asymptomatic. Undiagnosed cases may lead to infertility. Gonorrhea is easily transmitted.

Transmission of Gonorrhea
Infection with Gonorrhea occurs by direct inoculation; vaginally, orally, penile, ocular, and anally. Male to female transmission is up to 90%. Female to male transmission is approximately 20%.

Gonorrhea Symptoms
Many people who have the STD Gonorrhea are not aware of their infection. When symptoms of Gonorrhea do present, they usually occur 2 to 30 days after exposure. The symptoms are similar to Chlamydia except the discharge is typically more purulent, and extra-genital manifestations are more likely. 

Men often have a penile discharge that is purulent. They may also have a burning sensation while urinating. Many men also present with itching, abnormal sensations, or burning of the penis, especially itching and abnormal sensations at the tip of the penis. Occasionally there may be painful testicular swelling which may signify more serious disease. 

Women may have a vaginal discharge, vaginal itch, painful intercourse, burning urination, and lower abdominal pain, nausea and or fever. 

If there has been anal inoculation, symptoms in that region include the following: Anal itching, painful defecation, and rectal fullness. 

In cases of oral inoculation there may be mucopurulent discharge or sore throat. 

Very rarely Neisseria gonorrhea causes genital or nongenital skin ulcers. Another rare manifestation of Gonorrhea is penile venereal edema. This is said to occur when the penile tissue actually becomes swollen. 

Gonorrhea Complications
Although Gonorrhea often has no symptoms, its complications may be devastating. Gonorrhea can lead to PID (pelvic inflammatory disease.) This can be fatal or may cause infertility. Also, it can cause epididymitis which may cause infertility in men.

Also, as opposed to Chlamydia where the disease is not often widespread, disseminated Gonorrhea may occur causing polyarthralgia, and tenosynovitis of the elbows, wrists, and knees. Purulent arthritis, often presenting as a painful swollen knee joint may occur. Diffuse, whole body rashes may also occur. Very rarely, disseminated Gonnorhea can cause damage to the internal organs.

Gonorrhea Testing
Gonorrhea testing has become very simple. For most patients, a urine sample is often all that is needed to provide the doctor with for testing.

Tests done for Gonorrhea and Chlamydia can vary greatly in accuracy when performed by different healthcare providers. Here are some important facts on Gonorrhea testing.

  1. The sensitivity of tests, that is the percentage of cases of disease that is actually picked up from a Gonorrhea or Chlamydia test, varies from 60% to 95%. Therefore it is vital to know which test will yield the highest sensitivity for each patient. At Current New York Medical P.C., we know which tests are best for each individual.
  2. Improper selection of tests can lead to falsely negative test results which we often find in test results of patients that are referred from other centers to our office.

  3. Improper collection or handling of patient specimens can lead to false positive and false negative test results.

  4. A proper test for Gonorrhea or Chlamydia for one site of the body is not necessarily the proper test for another site of the body.

  5. Emerging strains of Gonorrhea and Chlamydia demands vigilance in surveillance. For example, 2007 saw a variant of Chlamydia which would not normally be picked up on the usual most accurate testing. A doctor needs to be aware of the limitations of testing according to emerging strains of microbes.


Treatment of Gonorrhea
Once a patient is diagnosed with Gonorrhea or Chlamydia, the provider giving the news should know how to properly treat the patient, he/she should know the risk of treatment failure, the course of disease after treatment, and should understand the subtle signs and symptoms of serious disease. 

It is very important to refrain from sexual relations until treatment is completed. Also, all partners should be tested and/or treated as the risk of re-infection is high. 

Often, the treatment of uncomplicated cases are quite simple. Many cases require just one day of treatment. However, in certain situations, it may be advisable to repeat testing after treatment as there are some resistant strains emerging in certain populations. 

Of note, a resistant strain of Gonorrhea has recently emerged and has rapidly spread across the U.S.A. and the world. A medical practitioner must understand these changes and know how to properly address this in his/her practice. The treatment of choice for Gonorrhea is often no longer a pill, rather it is an injection of Ceftriaxone. At Current New York Medical P.C., we are up to date on such resistant strains and have Ceftriaxone in stock at all times to assure adequate treatment. 


This material was written by Michael Shirazi MD.  It is meant for informational purposes only.  All material is protected under U.S. Copyright Law.


Copyright © 2011 Dr. Shirazi - All Rights Reserved