International Journal of

Guideline Article
Dermatology and Venereology
OPEN

National Guidelines on Diagnosis and Treatment

of Gonorrhea in China (2020)#
National Center for STD Control, Chinese Centers for Disease Control and Prevention; Committee of
STD, Branch of Dermatovenereology, Chinese Medical Association; Committee of STD, Chinese
Dermatologist Association; Qian-Qiu Wang1,∗, Rui-Li Zhang2, Quan-Zhong Liu3, Jin-Hua Xu4,
Xiao-Hong Su1, Yue-Ping Yin1, Shu-Zhen Qi1, Dong-Mei Xu5, Ping-Yu Zhou6, Yu-Ye Li7,
Xiao-Fang Li1, Min-Zhi Wu8, Xian-Biao Zou9, Li-Gang Yang10, Xiang-Sheng Chen1,
Xiang-Dong Gong1, Guo-Jun Liang1, Juan Jiang1, Hao Cheng11, Feng-Qin Ge1
1
Hospital for Skin Diseases (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College
and National Center for STD Control, Chinese Centers for Disease Control and Prevention, Nanjing, Jiangsu 210042, China;
2
Department of Dermatology, Affiliated Wuxi No. 2 People’s Hospital of Nanjing Medical University, Wuxi, Jiangsu 214002, China;
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3
Department of Dermatology, General Hospital of Tianjing Medical University, Tianjing 300052, China; 4 Department of
Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China; 5 Department of Neurology, Ditan Hospital of Capital
Medical University, Beijing 100050, China; 6 Department of Dermatology, Shanghai Hospital for Skin Disease and STD of Tongji
University, Shanghai 200050, China; 7 Department of Dermatology, The First Affiliated Hospital of Kunming Medical University,
Kunming, Yunnan 650032, China; 8 Department of Dermatology, The 5th People’s Hospital of Suzhou, Suzhou, Jiangsu 215007
China; 9 Department of Dermatology, The First Affiliated Hospital of General Hospital of PLA, Beijing 100048, China; 10 Department
of Dermatology, The Skin Disease Hospital of Southern Medical University, Guangzhou, Guangdong 510091 China; 11 Department
of Dermatology, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310020, China.

Abstract
Gonorrhea is one of the main sexually transmitted diseases in China. It mainly affects the genitourinary tract, and its
clinical manifestations vary from asymptomatic to complicated types. The diagnosis of gonorrhea should be based on
the patient’s epidemiological history, clinical manifestations, and laboratory examination results. Treatment should be
prompt and standardized and should involve the recommended treatment regimens. Patients should be appropriately
followed up after treatment. The antimicrobial resistance of gonococcal isolates has become a severe problem of clinical
concern. In order to provide technical guidance of the diagnosis and treatment of gonorrhea for health care workers, the
authors developed the guidelines based on the version of 2014, which will be of important in the standardizing medical
care of gonorrhea, and further facilitating control and prevention of the disease.
Keywords: gonorrhea, diagnosis, treatment, guidelines

Introduction
Gonorrhea is a classic sexually transmitted disease caused
#
This Gonorrhea Guidelines in Chinese has been published on Chinese Journal by infection with the bacterium Neisseria gonorrhoeae (N.
of Dermatology, 2020,53(3):168-179. gonorrhoeae). It is characterized primarily by suppurative
∗ Corresponding author: Dr. Qian-Qiu Wang, Hospital for Skin Diseases (Institute
inflammation of the urogenital mucosa, and the most
of Dermatology), Chinese Academy of Medical Sciences and Peking Union
Medical College and National Center for STD Control, Chinese Centers for common manifestations are urethritis in men and cervicitis
Disease Control and Prevention, Nanjing, Jiangsu 210042, China. in women. The most frequent local complications of
E-mail: wangqianqiunj@126.com.
gonorrhea are epididymitis in men and pelvic inflammatory
Conflicts of interest: The authors reported no conflicts of interest.
disease in women. Other sites of primary infection include
Copyright © 2020 Hospital for Skin Diseases (Institute of Dermatology), Chinese
the pharynx, rectum, and conjunctiva. Spread of N.
Academy of Medical Sciences, and Chinese Medical Association, published by
Wolters Kluwer, Inc. gonorrhoeae through the blood can result in disseminated
This is an open access article distributed under the terms of the Creative gonococcal infections, but these are rare in clinical settings.
Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-
ND), where it is permissible to download and share the work provided it is
properly cited. The work cannot be changed in any way or used commercially
Diagnosis
without permission from the journal.
Epidemiological history
International Journal of Dermatology and Venereology (2020) 3:3
Received: 15 December 2019, Accepted: 5 January 2020 Factors associated with gonorrhea include high-risk sexual
doi: 10.1097/JD9.0000000000000072 behavior, a history of multiple sexual partners or partners

129
Wang et al., Int J Dermatol Venereol (2020) 3:3
with gonococcal infections, and a history of close contact
with patients who have gonorrhea. Gonorrhea in children
may be associated with a history of sexual abuse, and
gonorrhea in newborns is associated with infected
mothers.1
Clinical manifestations
Uncomplicated gonorrhea
Uncomplicated gonorrhea in men
Gonococcal urethritis is the most common manifestation in
men, although about 10% of infected men are asymptom-
atic. The incubation period ranges from 2 to 10 days, with
an average of 3–5 days. Urethral discharge and dysuria are
the most common symptoms in symptomatic patients, with
some men experiencing urgency, frequent urination, or
urinary itch. The urethral discharge in some patients
becomes mucinous while also decreasing in volume, and a
large amount of purulent discharge may appear several days
after infection. In addition, the urethra of patients with
gonorrhea becomes flushed and swollen. Patients with
severe symptoms may develop balanoposthitis, in which the
glans and prepuce appear red and swollen with exudation,
erosion, edema, or even phimosis. Urethral fistulae and
sinuses are occasionally observed. A small number of
patients may experience posturethritis, swelling of the
perineum, and/or painful penile erection at night. Even in
untreated patients, obvious symptoms and signs generally
decrease gradually after 10–14 days and largely disappear
after one month; however, these patients are not cured.
Gonorrheal infection can continue to spread to the posterior
urethra or upper genital tract and may even be accompanied
by complications.1-2
Uncomplicated gonorrhea in women
About 50% of women infected with N. gonorrhoeae have
no obvious symptoms, making it difficult to determine the
incubation period.
Cervicitis. Vaginal discharge is increased in volume and
becomes purulent. The cervix becomes red and swollen,
with mucopurulent discharge at the external os of the
cervix. Some women may experience dyspareunia,
vulvodynia, or itching.
Urethritis. Women with gonorrhea may experience
dysuria, urgency, frequency, or hematuria. The urethral
orifice may become flushed and swollen. Squeezing
the urethra may release a small amount of purulent
discharge.
Bartholinitis. Bartholinitis is usually unilateral and is
characterized by localized swelling and sensations of heat
and pain in the labia major. These symptoms may progress
to abscess formation, fluctuation of symptoms, and severe
pain. Bartholinitis may also be accompanied by systemic
symptoms and fever.
Perianal inflammation. Women with gonorrhea may
experience perianal flushing, mild edema, and purulent
exudate with pruritus.1-2
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International Journal of Dermatology and Venereology
Gonorrhea in children
Urethritis and balanoposthitis. These symptoms often
occur in boys and are accompanied by dysuria and
urethral discharge. Physical examination shows that the
prepuce and urethra are red and swollen, and purulent
discharge may be present.
Vulvovaginitis. Vulvovaginitis may occur in girls and
can manifest as vaginal pain accompanied by frequency
and urgency of urination as well as purulent discharge.
Physical examination shows that the vulva, vagina, and
urethra are red and swollen, with purulent discharge from
the vagina and urethra.1-2
Complicated gonorrhea
Complicated gonorrhea in men
Epididymitis. Epididymitis in men with gonorrhea often
manifests as unilateral epididymal swelling and severe
pain. Reflex pain is present on the same side of the groin
and lower abdomen. Physical examination shows swelling
of one side of the scrotum; edema of the scrotal skin;
redness, heat, and pain of the epididymis; and purulent
discharge from the urethral meatus.
Seminal vesiculitis. Men with complicated gonorrhea
may experience dysuria, frequency, and urgency of
urination; terminal hematuria; hemospermia; and lower
abdominal pain during the acute stage of the disease.
Rectal examination can reveal enlarged seminal vesicles
and severe tenderness.
Prostatitis. Men with complicated gonorrhea may
experience chills, fever, dysuria, frequency and urgency
of urination, terminal hematuria, purulent discharge from
the urethral meatus, pain or discomfort in the perineumor
suprapubic region, and rectal tenesmus during the acute
stage of the disease. Rectal examination shows enlarge-
ment and tenderness of the prostate. Severely infected
patients may experience acute urinary retention and/or
prostatic abscesses.
Parafrenular gland (Tyson gland) inflammation or
paraurethritis and abscesses. These symptoms are rare,
observed in <1% of infected patients.1-2 They are character-
ized by painful swelling on one or both sides of the frenulum
and pus discharge through the glandular lumen.
Cowper gland inflammation and abscess. This compli-
cation is also rare, manifesting as perineal pain, acute
urinary retention, and a tender mass on digital rectal
examination.
Cellulitis and abscesses around the urethra. These
symptoms are also rare, manifesting as pain and swelling
on the side of the abscess and rupture to form a fistula
around the urethra. Physical examination can reveal
fluctuating, tender masses that may appear in the navicular
fossa.
Urethral stricture. Urethral strictures are rare and
caused by cellulitis, abscess, or fistulae around the urethra.
This complication manifests as urinary tract infarction
(difficulty urinating and dysuria), greater frequency of
urination, and urinary retention.1-2
Wang et al., Int J Dermatol Venereol (2020) 3:3
Complicated gonorrhea in women
Gonococcal cervicitis can lead to pelvic inflammation,
including endometritis, salpingitis, ovarian cysts, pelvic
peritonitis, pelvic abscesses, or perihepatitis. Gonococcal
pelvic inflammation can cause infertility, ectopic pregnan-
cy, chronic pelvic pain, and other adverse consequences.
Pelvic inflammatory disease. The clinical manifestations
of this condition may be nonspecific, including systemic
symptoms such as chills, fever (>38°C), anorexia, nausea,
and vomiting. Patients may also experience lower
abdominal pain, irregular vaginal bleeding, and abnormal
vaginal discharge. Abdominal and pelvic examinations
may show lower abdominal tenderness, cervical motion
tenderness, adnexal tenderness, pelvic masses, and puru-
lent discharge at the cervical os.
Perihepatitis. Perihepatitis is characterized by sudden
pain in the upper abdomen, which may become aggravated
by deep breathing and coughing. It may be accompanied
by fever, nausea, vomiting, and other systemic symptoms.
Palpation shows obvious tenderness in the right upper
abdomen, and chest radiographs show a small amount of
pleural effusion on the right side.1-2
Gonorrhea at other sites
Conjunctivitis
Gonococcal conjunctivitis often manifests as acute suppura-
tive conjunctivitis. In newborns, gonococcal conjunctivitis
appears 2–21 days after birth, and symptoms are usually
bilateral. In adults, gonococcal conjunctivitis can be unilateral
or bilateral. In this condition, the conjunctiva is congested and
edematous, with large amounts of purulent discharge; the
sclera has clouding-like congestive erythema; and the cornea
is turbid and foggy, with ulcers or perforations.
Pharyngitis
Gonococcal pharyngitis may occur via oral–genital
intercourse. More than 90% of patients have no obvious
symptoms, while others experience discomfort, burning,
or pain in the pharynx.3 Physical examination shows
congestion of the pharyngeal mucosa with mucus or
purulent discharge in the posterior pharyngeal wall.
Proctitis
Gonococcal proctitis may be due to anal–genital inter-
course; in women, however, it may also be caused by anal
contact with vaginal discharge. Most patients have no
obvious symptom, although some may experience pruritus
and burning of the anus, a mucinous or mucopurulent
discharge from the anus, or a small amount of rectal
bleeding. Severely infected patients have obvious symp-
toms of proctitis, including rectal pain, tenesmus, and
bloody stool. Physical examination shows congestion,
edema, and erosion of the anal and rectal mucosa.1-2
Disseminated gonorrhea
Disseminated gonorrhea in adults
This condition is rare in clinical settings. Affected patients
often experience fever, chills, and general malaise, and
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arthritis–dermatitis syndrome is common. Patients with
disseminated gonorrhea may develop a hemorrhagic or
pustular skin rash at the extremities, often involving the
small joints of the fingers, wrists, and ankles. Some patients
may experience joint pain, tenosynovitis, or suppurative
arthritis, and some may develop gonococcal meningitis,
endocarditis, pericarditis, or myocarditis.4-5
Neonatal disseminated gonorrhea
This condition is also rare. Neonates with disseminated
gonorrhea may develop gonococcal septicemia, arthritis,
or meningitis.4-5
Laboratory examinations
Microscopy
Gram-stained male urethral discharge smears that show
gram-negative diplococci inside polymorphonuclear cells
is diagnostic for uncomplicated gonorrhea in men, with
a sensitivity of ≥95% and a specificity of 97%. Gram
staining is not recommended for the diagnosis of other
types of gonococcal infection, including pharyngeal and
rectal infection in men and women and cervical infection in
women.6-7
Culture
Culture is the test of choice for the diagnosis of gonorrhea.
It is suitable for the examination of all clinical specimens
except urine in both men and women. N. gonorrhoeae can
be preliminarily identified by colony patterns, Gram
staining of cultures, and oxidase tests; identification can
be confirmed by sugar fermentation and chemical
reactions if necessary. Culture methods have a specificity
of 100% and a sensitivity of 85%–95%. Moreover,
cultured gonococcal isolates can be preserved for
antimicrobial sensitivity tests.6-7
Nucleic acid tests
Nucleic acid tests have higher sensitivity than culturing
and are thus appropriate for the detection of various
types of clinical specimens. N. gonorrhoeae DNA and
RNA can be detected by polymerase chain reaction.8
These tests should be performed in specific nucleic
acid amplification laboratories approved by relevant
authorities.
Diagnostic classification
The diagnostic classification of gonorrhea should be based
on a comprehensive analysis of the patient’s epidemiologi-
cal history, clinical manifestations, and laboratory test
results. Caution should be exercised, however, in making a
diagnosis.
Patients with suspected gonorrhea
Patients suspected of having gonorrhea are those with
an appropriate epidemiological history and clinical
manifestations.
Wang et al., Int J Dermatol Venereol (2020) 3:3
Patients with confirmed gonorrhea
Patients confirmed as having gonorrhea are those with an
appropriate epidemiological history and clinical manifes-
tations who also have positive results on one or more
laboratory tests.
Treatment
General principles of treatment
The general principles of treatment include timely,
sufficient, and regular administration of medications;
the use of regimens recommended for specific manifes-
tations in individual patients; follow-up after treatment;
and notification and treatment of each patient’s sexual
partners. Patients should also be told to avoid sexual
contact before they or their partners complete their
treatment courses. Attention should be paid to infection
with multiple pathogens. Generally, patients with gonor-
rhea should be tested for Chlamydia trachomatis infection
or administered agents to treat C. trachomatis, since
coinfection with C. trachomatis is detected in 10%–40%
of people with gonorrhoea.9–13 Patients should also
undergo serological testing for syphilis and human
immunodeficiency virus, and they should be counseled
about the risks of these diseases.
Recommended treatment regimens
Uncomplicated gonorrhea
Patients with gonococcal urethritis, cervicitis, and proctitis
should receive a single dose of 1 g ceftriaxone administered
intramuscularly or intravenously, or a single dose of 2 g
spectinomycin (4 g for patients with gonococcal cervicitis)
administered intramuscularly. Alternative treatments in-
clude a single intramuscular dose of 1 g cefotaxime or
another third-generation cephalosporin. If C. trachomatis
infection cannot be excluded, an additional anti-C.
trachomatis treatment is warranted.1,14-15
In recent years, strains of gonococci with decreased
sensitivity to broad-spectrum cephalosporins and greater
antimicrobial resistance have emerged in many regions
worldwide.16-17 Gonorrhea treatment guidelines of the
World Health Organization and the United States Centers
for Disease Control and Prevention as well as guidelines in
Europe have recommended treatment with both ceftriax-
one and azithromycin.14-15,18 Because surveillance data
showed that 18.6% of N. gonorrhoeae isolates from 2013
to 2016 were resistant to azithromycin, this agent is no
longer recommended for first-line treatment in China. In
addition, 10.8% of isolates showed decreased sensitivity to
ceftriaxone, and cephalosporin-resistant N. gonorrhoeae
isolates (ST1407 and FC428) were also identified in
China.19-20 Therefore, it is important to monitor the
epidemiology of antimicrobial resistance and the clinically
curative effects of various antimicrobials and to adjust
treatment regimens to prevent treatment failure.21–28
Because nonresponse to the recommended dose of
ceftriaxone may indicate reinfection or treatment failure,
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International Journal of Dermatology and Venereology
antimicrobial sensitivity should be tested. Patients con-
firmed to have undergone failed treatment can be treated
with an increased dose of ceftriaxone (consisting of 1–2 g
injected intramuscularly or administered intravenously for
three days). Alternatively, patients can be switched to
spectinomycin treatment or administered a single intra-
muscular injection of 240,000 IU of gentamicin.29-30
Gonorrhea in children
Children weighing≥45 kg should be treated as adults.
Children weighing <45 kg should be treated with a single
intramuscular injection of 25–50 mg/kg of ceftriaxone
(maximum dose not exceeding the adult dose) or a single
intramuscular injection of 40 mg/kg spectinomycin (maxi-
mum dose of 2 g). If Chlamydia infection cannot be
excluded, an additional anti-C. trachomatis treatment is
warranted.
Gonococcal epididymitis, prostatitis, and seminal
vesiculitis
Patients with these conditions should be administered 1 g
ceftriaxone intramuscularly or intravenously once daily
for 10 days. Alternatively, these patients can be treated
with 1 g cefotaxime intramuscularly once daily for 10
days. If C. trachomatis infection cannot be excluded,
patients should also be administered 100 mg oral doxycy-
cline twice daily for 10–14 days.
Gonococcal pelvic inflammatory diseases
The regimen recommended for outpatients is administra-
tion of 1 g ceftriaxone intramuscularly or intravenously
once daily for 10 days plus 100 mg doxycycline orally
twice daily for 14 days and 400 mg metronidazole
orally twice daily for 14 days.
Several inpatient treatment regimens have been recom-
mended for patients with severe illness. Recommended
Regimen A for hospitalized patients includes 1 g ceftriax-
one, injected intramuscularly or intravenously once every
24 hours, or 2 g cefotetan, injected intravenously once
every 12 hours, plus100 mg doxycycline, administered
intravenously or orally every 12 hours. Note: If the patient
can tolerate it, doxycycline should be administered orally.
The duration of cefotetan treatment should not be less than
one week, as long as the patient’s condition allows.
Patients who show improvements in clinical symptoms
within 72 hours after treatment should discontinue
parenteral treatment during the first week. These patients
should be treated with 100 mg oral doxycycline twice daily
plus 400 mg oral metronidazole twice daily for a total of
14 days of treatment.
Recommended Regimen B includes 900 mg clindamycin
injected intravenously once every 8 hours, plus a loading
dose of 2 mg/kg gentamicin injected intravenously or
intramuscularly, followed by a maintenance dose of
1.5 mg/kg gentamicin once every 8 hours or once a day.
Please note that patients who show improvements in
clinical symptoms within 24 hours can stop parenteral
treatment; they should then be treated by oral administration
Wang et al., Int J Dermatol Venereol (2020) 3:3
of 100 mg doxycycline twice daily or 450 mg clindamycin
four times daily for 14 consecutive days. Intravenous
doxycycline may induce pain at the injection site and has
no advantage over oral doxycycline in patients who tolerate
the latter. Pregnant and lactating women should avoid
tetracycline and doxycycline, and metronidazole should be
avoided during the first trimester of pregnancy.1,31
Gonorrhea at other sites
Gonorrheal conjunctivitis
Newborns should be treated with 25–50 mg/kg intrave-
nous or intramuscular ceftriaxone once daily for three
consecutive days, with the total dose not exceeding 125
mg. Children weighing <45 kg should be treated with 50
mg/kg ceftriaxone administered intramuscularly or intra-
venously once daily for three days, with a maximum dose
of 1 g. Children weighing ≥45 kg should be treated with
the regimen for adults, consisting of 1 g ceftriaxone
administered intramuscularly or intravenously once daily
for three days or 2 g intramuscular spectinomycin once
daily for three days. The eyes should be washed every hour
with normal saline. Spectinomycin should not be admin-
istered to newborns. Mothers of infected newborns should
be examined, and those with gonorrhea should be treated.
Newborns should be hospitalized and checked for
disseminated infection.
Gonorrheal pharyngitis
Patients with gonococcal pharyngitis should be treated
with a single dose of 1 g ceftriaxone administered
intramuscularly or intravenously or a single dose of 1 g
cefotaxime administered intramuscularly. If C. trachoma-
tis infection cannot be excluded, additional anti-C.
trachomatis treatment is warranted. Spectinomycin is
not recommended because of its poor efficacy in patients
with gonococcal pharyngitis.
Disseminated gonorrhea
Newborns should be treated with 25–50 mg/kg/day
ceftriaxone administered intravenously or intramuscularly
once daily for 7–10 days; if meningitis is present, treatment
should continue for up to 14 days. Children weighing <45
kg are treated for gonococcal arthritis with 50 mg/kg
ceftriaxone administered intramuscularly or intravenously
once daily for 7–10 days. Children weighing <45 kg are
treated for gonococcal meningitis or endocarditis with 25
mg/kg ceftriaxone administered intramuscularly or intra-
venously twice daily for 14 days (meningitis) or 28 days
(endocarditis). Children weighing >45 mg are treated
similarly as adults. Hospitalization is recommended to
check for endocarditis or meningitis. Treatment consists of
1 g ceftriaxone administered intramuscularly or intrave-
nously once daily for at least 10 days. Patients with
gonococcal meningitis should be treated for about two
weeks, and those with gonococcal endocarditis should be
treated for more than four weeks. If C. trachomatis
infection cannot be excluded, additional anti-C. tracho-
matis treatment is warranted. Note: Open drainage is not
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necessary for patients with gonococcal arthritis except for
those with gonococcal arthritis of the hip joint. Joint
exudates, however, should be repeatedly aspirated. Anti-
biotics should not be directly injected into joint cavities.
Nonsteroidal anti-inflammatory drugs can relieve pain and
help prevent recurrent joint exudate.
Gonorrhea during pregnancy
Treatment regimens in pregnant women are dependent on
the type of infection, although erythromycin or amoxicillin
is recommended for pregnant women with suspected or
confirmed C. trachomatis coinfection. Pregnant women
should never be treated with fluoroquinolones or tetracy-
cline32
Follow-up
Following treatment with the recommended regimens,
patients with uncomplicated gonorrhea in the genitouri-
nary tract should be screened by gonococcus culture if they
experience persistent symptoms or signs of gonorrhea,
gonococcal infection of the pharynx, pelvic inflammatory
disease or disseminated gonococcus infection, or infection
during pregnancy. Patients who have sexual contact with
untreated sexual partners should also be screened, as
should all children who have been treated for gonorrhea.
N. gonorrhoeae cultures should be performed at least five
days after the completion of treatment, and nucleic acid
amplification tests should be performed at least three
weeks after treatment completion. Treatment failure or
infection with antimicrobial-resistant strains should be
reported.
The diagnosis and treatment of gonococcal epididymitis
should be reevaluated if the symptoms do not improve
significantly within three days after treatment. Patients
with gonococcal pelvic inflammatory disease should be
followed up within three days after treatment, although
patients with fever should be followed up within 24 hours.
If their condition does not improve, they should be
admitted to the hospital. Patients should experience
obvious clinical improvement within three days (abate-
ment of fever, abdominal or adnexal tenderness, or
cervical motion tenderness). Patients who do not improve
within three days may need to be admitted to the hospital
for treatment, other diagnostic tests, or surgical consulta-
tion. Patients with gonococcal meningitis and endocarditis
should be referred to an appropriate specialist.
Sexual partner management
Adult patients with gonorrhea are required to have their
sexual partners checked and treated for gonorrhea. All
individuals who had sexual contact with the patient before
the onset of symptoms or within two months before
diagnosis should be notified and examined for N.
gonorrhoeae and C. trachomatis. Patients should be
instructed to avoid sexual intercourse before treatment
is completed or when they and their partners still have
Wang et al., Int J Dermatol Venereol (2020) 3:3
symptoms. When a neonate is diagnosed with gonococcal
infection, the mother of the infant and all of her sexual
partners within two months before delivery should be
examined and treated. Men who have sexual contact with
women who have gonococcal pelvic inflammatory disease
within two months before the appearance of symptoms
should be examined and treated, even if they are
asymptomatic.
Source of funding
This study was supported by the Union Innovation Project
of the Chinese Academy of Medical Sciences (No. 2016-
I2M-3021) and the National Natural Science Foundation
of China (No. 81772209 and No. 81601804).
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