Gonorrhea and multiple site infection: case report and screening opportunities

Neisseria gonorrhoeae is one of the most prevalent sexually transmitted pathogen with the vast majority of reported cases diagnosed at urogenital sites. While urethral gonococcal infections in men usually present with penile discharge and dysuria, pharynx and rectal infections are often asymptomatic. The Centers for Disease Control and Prevention recommend that sexually active men who have sex with men (MSM) be screened at least annually for urethral, pharyngeal and rectal gonorrhea, considering sexual exposure history, and every 3 to 6 months if higher-risk behaviours are reported. However, despite CDC's guidelines screening recommendations, low rates of testing among MSM are reported, such as urethral-only screening which may entail missing pharyngeal and rectal gonococcal infection. We present a case report of gonorrhea with multiple anatomic sites infection in a young MSM. Inspite of clinical presentation involving urogenital symptoms only, a sexual history based valutation allowed to detect asymptomatic pharyngeal and rectal infections.