Infection may ascend from endocervix to the upper genital tract causing endometritis, salpingitis and pelvic inflammatory disease. Late sequelae include tubo-ovarian abscess and peri-hepatitis (Fitz-Hugh-Curtis syndrome).
Urethritis in females may cause dysuria and frequency without much discharge and be misdiagnosed as cystitis.
Infection of one or both Bartholin’s glands just inside the vulva may result in local pain, swelling and tenderness.
Anorectal infection secondary to genital infection is common in females. Anal sex may result in anorectal infection in both males and females. Anorectal infection may be asymptomatic or may present as a mucopurulent anal discharge and anal discomfort, including discomfort on defaecation.
Oral sex may result in oropharyngeal infection which may be asymptomatic or present as sore throat or pain on swallowing.
Conjunctivitis may occur in neonates as a result of transmission from an infected mother during parturition. Gonococcal conjunctivitis may occur as a local outbreak in older children or adults due to close contact or autoinoculation in communities with high carrier rates of gonorrhoea and poor hygiene standards.
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