Differential Diagnosis for Gonorrhea
The following differential diagnosis is organized into categories to help guide the thought process:
Single Most Likely Diagnosis
- Chlamydia: This is often considered due to the high frequency of co-infection with gonorrhea, making it a common and likely diagnosis to consider alongside gonorrhea.
Other Likely Diagnoses
- Syphilis: Another sexually transmitted infection (STI) that can present with similar symptoms, such as genital ulcers or discharge.
- Herpes Simplex Virus (HSV): Can cause genital ulcers that might be confused with the symptoms of gonorrhea.
- Trichomoniasis: A sexually transmitted infection caused by a parasite, which can lead to vaginal discharge and irritation similar to gonorrhea.
- Urethritis (non-gonococcal): Inflammation of the urethra not caused by gonorrhea, often due to other bacteria like Chlamydia or Mycoplasma genitalium.
Do Not Miss Diagnoses
- Pelvic Inflammatory Disease (PID): A serious complication of untreated gonorrhea or other STIs, leading to inflammation of the female reproductive organs, which can cause infertility and chronic pain if not promptly treated.
- Epididymitis: Inflammation of the epididymis (a tube at the back of the testicle that stores and carries sperm), which can be caused by gonorrhea and lead to severe pain and potential infertility.
- Septic Arthritis: A condition where the joint space is infected, which can be a rare but serious complication of disseminated gonococcal infection.
Rare Diagnoses
- Lymphogranuloma Venereum (LGV): A rare STI caused by certain strains of Chlamydia trachomatis, which can lead to symptoms similar to gonorrhea, including genital ulcers and lymphadenopathy.
- Granuloma Inguinale: A rare STI caused by Klebsiella granulomatis, characterized by genital ulcers without lymphadenopathy.
- Molluscum Contagiosum: A viral infection that causes small, pearly, or flesh-colored bumps on the skin, which can be sexually transmitted and might be considered in the differential for genital lesions.