Intensive Care Medicine (ICM) Practice Exam

If a patient is improving after treatment for gonorrhea but still has symptoms, what is the most likely explanation?

1. You treated too late, and the gonorrhea disseminated

2. The gonorrhea was an antibiotic resistant strain

3. The patient never had either infection, and developed an iatrogenic urethritis

4. An underlying infection that is not effectively treated by either drug

The correct answer is: An underlying infection that is not effectively treated by either drug

In cases where a patient shows improvement after treatment for gonorrhea yet continues to experience symptoms, the most likely explanation is the presence of an underlying infection that is not effectively treated by the antibiotics used for gonorrhea. This can occur if there is a co-existing infection, such as chlamydia or another sexually transmitted infection, that requires different treatment or if there are other etiologies, such as non-infectious causes like irritation or inflammation in the urogenital tract. It’s important to recognize that while the treatment for gonorrhea may effectively eliminate that specific infection, persistent symptoms may point to other pathogens or conditions that weren’t originally addressed. In this scenario, further evaluation and possibly different diagnostic testing would be warranted to identify another cause of the symptoms that are not resolved by the initial treatment.