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Gonorrhoea suspected symptomatic — DFSRH MCQ

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HardSTI diagnosis and managementGonorrhoea suspected symptomaticDFSRH

A 28-year-old man has urethral discharge and dysuria 5 days after sex with a new partner. Microscopy shows intracellular Gram-negative diplococci; NAAT and culture are sent. He has no cephalosporin allergy. What is the most appropriate management?

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Correct answer: E — Ceftriaxone 1 g intramuscularly and partner notification

Microscopy strongly suggests gonorrhoea, and treatment should not wait for culture in a symptomatic patient. Ceftriaxone is first-line and culture supports antimicrobial susceptibility surveillance. Doxycycline alone would miss gonorrhoea but may be added if chlamydia has not been excluded depending on local protocol.

Reference: BASHH Gonorrhoea Guideline; BNF