Gonorrhea relates to a highly contagious and infectious diseases, in which the affected mucosa of the urogenital tract, but possibly infected oropharyngeal or rectum. Suffer from the disease, both men and women.
Causes
It causes gonorrhea gonococcus (Neisseria gonorrhoeae), named after the physician-researcher Albert Neisser. The disease is transmitted only from a patient person to person.
The main route of transmission of gonorrhea is sexual (genital), but possible contamination with anogenital and oral sex.
In addition, the known vertical route of infection - infected during birth the baby passes through the birth canal ailing mother.
It is not excluded and consumer pathway, but its authenticity has not been established as the causative agent is unstable in the environment.
Kinds
Distinguish genital and extra (non-sexual) gonorrhea. For genital gonorrhea characteristic lesion of urogenital organs.
The group extragenital gonorrhea include:
- anorectal gonorrhea localization (inflammation of the rectum)
- gonorrhea bone and muscular systems (gonorrheal arthritis),
- gonorrheal defeat conjunctiva (blennophthalmia)
- gonococcal pharyngeal disease (gonococcal pharyngitis).
According to the course of the disease is divided into fresh, chronic and latent gonorrhea.
About fresh gonorrhea say when the infection occurred less than 2 months ago. Fresh gonorrhea is divided into acute, subacute and torpid (no complaints, but there is a minor release).
If the infection occurred more than 2 months ago, diagnosed with chronic gonorrhea.
Latent or latent gonorrhea has no clinical manifestations.
Symptoms of gonorrhea in women and men
The first signs of the disease appear after 2 -14 days after infection (incubation period). But in some circumstances (for example, antibiotics, having a good immunity), the first manifestations of the disease occur in 1-2 months.
Gonorrhea in men
Disease in men begins with the defeat of the urethra. Patients complain of discomfort (burning and itching), which occurs during urination. Also, urination becomes painful.
If you press a drop of pus appear on the glans penis. With involvement of the posterior urethra process becomes more frequent urination.
After sexual intercourse may cause bloody drops.
On examination, pronounced hyperemia (redness) of the foreskin and the glans.
Often inflamed inguinal lymph nodes, they enlarge and become painful.
In the case of an ascending infection gonorrhea spreads to the prostate gland, seminal vesicles, and affects the testicles. It is possible to increase in temperature, there are aching pains in the abdomen and problems with erection.
Gonorrhea in women
More than half of infected women gonorrhea occurs without clinical manifestations.
At the very beginning of the disease process involved in the urethra, vagina and cervix. Inflammation of the urethra occurs with pronounced signs: there are pale-yellow discharge from the urethra, itching and burning in the area, urination becomes painful.
When gonorrheal vaginitis and cervicitis distinguished from the genital tract purulent greenish leucorrhea with unpleasant odor, sometimes cheesy consistency. Also present are a burning sensation and itching, pain during sexual intercourse.
In case of irritation of the vulva infected secretions, it becomes inflamed, red and swells, joins itching in the perineum.
On examination, the mirrors indicated hyperemia (redness) of the cervix and purulent discharge from the cervical canal.
If the infection rises above, it affects the uterus and its appendages.
Diagnostics
Gonorrhea in women must be differentiated from other infections, sexually transmitted infections (trichomoniasis, candidiasis, bacterial vaginosis).
The men - with urethritis and prostatitis other infectious or noninfectious etiology.
Diagnosis of gonorrhea is set based on the characteristic of the patient complaints and clinical signs typical set during inspection.
But confirmation of the disease is necessary to conduct laboratory studies:
smear microscopy
To produce sampling swab material (precipitates) of urethral, cervical canal, vagina and anus. Before this, the physician handles listed anatomical structure swab soaked in saline. Before any analysis is necessary to refrain from urinating and stop taking antimicrobials for 4-5 days. All swabs are taken in duplicate. The first batch of smears stained with methylene blue and the other Gram.
The culture method
The essence of culture (bacteriological) of the method consists in the crop discharge from the urogenital tract in the culture media. Conclusion granted after 7 days, but gives 100% result. In addition, this method allows you to determine the sensitivity seeded gonococcal antibiotic.
immune fluorescence reaction
The method consists in the color smears with special dyes and then gonococci glow under a microscope.
Linked immunosorbent assay
The method consists in detecting antibodies to the causative agent, not smears taken for analysis, and urine.
Polymerase chain reaction (PCR)
PCR can be used swabs of the anatomical structures of the urogenital tract and urine. The method is effective, but expensive.
If diagnosed chronic gonorrhea (and repeated treatment failure, negative results microscopy and bacteriological analyzes) carried out a provocative test, after which the mucous the pathogen is detected.
Distinguish chemical, biological, thermal, alimentary and physiological provocation. For the most accurate result carried provocation combined (simultaneous administration of two or more samples). Swabs after challenge are taken in a day, two, and three.
*consult Federal standard for the diagnosis and treatment of gonorrhea, according to which this article is written.
gonorrhea treatment
Treatment gonorrhea usually carries dermatovenerolog. But in some cases (eg, complicated gonorrhea) Treatment of the disease in women has been a gynecologist, a urologist at the men.
Uncomplicated gonorrhea is treated on an outpatient basis, all other cases are hospitalized. Treatment is indicated both sexual partners, regardless of the test results. For the period of treatment is necessary to comply with sexual rest, personal hygiene (washing hands after the obligatory toilet and taking a shower), refuse to spicy food and alcohol.
acute gonorrhea
Causative treatment (removal causes disease) is delivered from gonococci and comprises administering antibacterial drugs.
When fresh gonorrhea appointed
- fluoroquinolone antibiotics (ciprofloxacin, abaktal, ofloxacin)
- cephalosporins (ceftriaxone, cefixime)
- macrolides (azithromycin, josamycin),
- tetracyclines (JUnidoks).
The course of treatment lasts for 7, a maximum of 10 days. Treatment it is advisable to combine with antibiotics active against chlamydia and ureaplasma (Since gonorrhea often occurs against the background).
The chronic form
Chronic gonorrhea treated significantly longer.
First assigned gonovaktsina courses on 6-8-10 intramuscular injection and preparations which stimulate non-specific immunity (pirogenal, ribonuclease), and only after that the therapy antibiotics.
Test samples shall be after the end of treatment and monthly during the three months.
Consequences and outlook
Launched gonorrhea risk of developing complications.
Among women:
- endometritis, adnexitis;
- obstruction of the fallopian tubes and infertility in women;
- bartholinitis among women;
- pelvioperitonit and tubo-ovarian abscess (in women);
- ectopic pregnancy.
men
- prostatitis;
- inflammation of the testicles and seminal vesicles;
- disruption of spermatogenesis;
- impotence;
- male infertility.
The prognosis for timely treatment of fresh gonorrhea favorable in chronic gonorrhea, both men and women, relatively favorable.
Sections of Diagnosis and Treatment of gonorrhea are written in accordance with the federal recommendationsApproved by the Academic Council of State TSNIKVI
