2009 European (IUSTI/WHO) guideline on the diagnosis and treatment of gonorrhoea in adults.

AETIOLOGY AND TRANSMISSION † Gonorrhoea (meaning ‘flow of seed’) and its related clinical manifestations are caused by infection with the bacterium Neisseria gonorrhoeae; † Infection predominantly involves the columnar epithelium of the urethra, endocervix, rectum, pharynx and conjunctivae. Although it usually remains localized to the initial sites of infection, it can ascend the genital tract to cause pelvic inflammatory disease (PID) and epididymo-orchitis or disseminate as bacteraemia; † Transmission is by genital–genital, genital–anorectal, oro– genital or oro–anal contact or by mother-to-child transmission at birth; † The highest incidence of gonorrhoea is in young adults (15– 29 years) and there is a disproportionate burden of disease in ethnic minority groups and men who have sex with men (MSM).