Examination features depend on the severity of infection, from minimal findings to systemic features of peritonitis and bacteraemia.
In severe disease, abdominal signs may mimic those for other causes of an acute abdomen, such as appendicitis.
- mucopurulent cervicitis
- cervical inflammation or bleeding
- cervical excitation (positive cervical motion test)
- adnexal tenderness, usually bilateral
- possible adnexal mass
- abdominal distension
- lower abdominal tenderness
- rebound tenderness/guarding (peritonism)
- right upper quadrant tenderness (associated with perihepatic inflammation, Fitz-Hugh-Curtis syndrome)
- pyrexia, tachycardia, hypotension
- clinical diagnosis has a positive predictive value of 65-90%.
In approximately 1% of GC cases, infection can spread haematogenously to a distant site, resulting in disseminated gonococcal infection with manifestations ranging from tendon or joint pain to meningitis or endocarditis.