Dayo noticed urethral discharge and pain on urinating 4 days before attending. He bought antibiotics from a pharmacy without a prescription. The discharge continued. A urethral swab confirmed gonococcal urethritis — gonorrhoea.
Logistics coordinator, Shomolu. 4-day history of urethral discharge and dysuria.
Gonococcal UrethritisDayo noticed the discharge on a Monday morning. He told himself it was a urinary infection and drank more water. By Tuesday the burning on urination was significant and the discharge was heavier. He went to a pharmacy and asked for 'something for infection' without specifying where the infection was.
The pharmacist gave him a broad-spectrum antibiotic — amoxicillin-clavulanate — and he began taking it. By Thursday the discharge had not reduced. He attended Mascot Healthcare on Friday.
The attending doctor asked directly: 'This is coming from the urethra — have you had unprotected sexual contact recently?' Dayo confirmed he had, approximately 5 days before symptoms started.
Gonococcal urethritis produces a characteristic cluster of symptoms that typically presents within 2–5 days of exposure.
Yellow-green, thick discharge — visible at the urethral meatus throughout the day.
Described as 'like passing hot sand' — worsening over the 4 days.
Visible inflammation at the opening of the urethra.
No epididymo-orchitis — the infection had not ascended.
No fever, no joint pain — uncomplicated urethritis only.
Dayo had taken 3 days of amoxicillin-clavulanate — a first-line antibiotic for many common infections, but not effective against Neisseria gonorrhoeae, which has developed extensive resistance to older penicillin-based antibiotics.
Gonorrhoea in Nigeria shows high rates of resistance to penicillins, tetracyclines, and fluoroquinolones. Current WHO and Nigerian guidelines recommend dual therapy with ceftriaxone and azithromycin for gonococcal infections.
A urethral swab was taken for Gram stain — the result was immediate: Gram-negative diplococci visible intracellularly, consistent with N. gonorrhoeae. Culture was sent for formal identification and sensitivity, though treatment was begun immediately based on the Gram stain result.
Full STI screen was taken: HIV rapid test, syphilis VDRL, chlamydia NAAT. All were negative except for the confirmed gonorrhoea. Partner notification was discussed — Dayo had one current partner who was contacted and attended for assessment within 48 hours.
Urethral swab Gram stain: Gram-negative intracellular diplococci. Clinical picture consistent with gonococcal urethritis. HIV, syphilis, chlamydia: all negative.
A single prescribed injection plus a single dose of oral medication, both given at the clinic. Advised to abstain from sexual contact until both he and his partner completed assessment and treatment.
Test of cure recommended at 7 days — repeat swab to confirm clearance. Patient educated on consistent condom use and the importance of partner notification for all recent contacts.
Test of cure at day 7: negative. Dayo's partner also tested positive and was treated. Both cleared at follow-up. Dayo has since attended for annual STI screening.
Gonorrhoea is the second most common bacterial STI globally. In Nigeria, rates are significant but under-reported due to pharmacy-based self-treatment without diagnosis. The consequence of undertreated gonorrhoea is ascending infection — epididymo-orchitis in men, pelvic inflammatory disease in women — both of which can affect fertility.
Partner notification — telling sexual contacts that they may have been exposed — is essential to breaking the transmission chain. Mascot Healthcare supports patients through this process sensitively and without pressure.
Urethral discharge combined with burning urination requires a swab — not a guess. Gonorrhoea does not respond to the antibiotics people often try first. A urethral swab provides a diagnosis in 15 minutes and directs treatment that actually works.
Walk in to Mascot Healthcare, Akoka — same-day consultation, transparent pricing, 4.9★ rated.