Gonorrhea

Causes, symptoms, diagnosis and prevention of gonorrhea

---

Causes of gonorrhea

Gonorrhea – an infectious disease transmitted mainly through sexual contact (although it can be transmitted through personal belongings of the patient). It is the causative agent of gonorrhea (gram negative diplococci). With the development of the disease affects mucous membranes of the urinary tract and bladder, sometimes the infection develops in the rectum and nasopharynx – it all depends on the preference of sexual intimacy between sexual partners. Gonococci die relatively quickly in the environment, but is very stable inside the body.

In men, the process can spread to the testicles, prostate gland, seminal vesicles, ejaculatory flows may also development of acute epididymitis (inflammation of epididymis). In women the most common complications of gonorrhea are inflammatory diseases of the appendages and uterus, leading to female infertility.

Gonococci penetrate to the lymph nodes, subepithelial connective tissue, sometimes into the bloodstream, causing gonococcal septicemia, arthritis, infectious meningitis , and endocarditis. During natural childbirth infection of the conjunctiva of the newborn's eyes, which further leads to ulceration of the cornea and scarring. Innate immunity of gonorrhea not, and it is not produced, so that any person can be infected repeatedly.

Gonorrhea

There are two forms of gonorrhea:

1. Fresh form is when the disease duration is less than 2 months from the date of the first clinical signs of gonorrhea. In turn, in phase with fresh forms of release:

· acute gonorrhea,

· subacute gonorrhea,

· torpid gonorrhea, characterized by minor symptoms of the disease, lasting no more than 2 months.

2. The chronic form is a slow process of gonorrhea lasting more than 2 months or with undetectable prescription disease.

Symptoms of gonorrhea

Primarily for gonorrhea characteristic manifestation of urethritis of different severity. The development of acute purulent urethritis begins with burning and itching in the anterior part of the urethra, appear mucus. After 3-4 days, the process reaches its peak. Visually marked by pronounced swelling of the lips of the urethra, their hyperemia (filling with blood), induration and tenderness to palpation.Urination becomes painful, urethral pus flows abundantly.

In acute gonorrhea the localization of the infection occurs in the anterior urethra, so the first portion of urine is always turbid, and the second – transparent. If the infection spreads to the posterior urethra, to the added symptoms of frequent urination and increasing pain at the end. Portion of urine is turbid in both portions.

Chronic gonorrhea usually develops as a result of delayed treatment of acute forms of the disease, weakening of the immune system of a patient or breach of the assigned treatment regimen. The symptoms of the disease at this stage usually depend on the extent of the process.

So, chronic gonorrheal urethritis is characterized by a slight discharge from the urethra (most often in the morning), however, detected in the urine purulent flakes and threads. Sluggish during the chronic infection is often accompanied by periodic exacerbations, similar to that of the acute urethritis. Typical of chronic gonorrhea and the development of various complications – prostatitis, epididymitis, vesiculitis and other.

It is known that the gonorrheal prostatitis is chronic and acute. In acute prostatitis patients report pain in the perineum and anus, frequent urination, increasing pain at the end of the process. Often, the General condition of the patient is violated, the person may be in a fever.

In chronic prostatitis patients complain of the weakening of erection, frequent pollutions, and a feeling of heaviness in the perineum, premature ejaculation. On palpation, the prostate is enlarged. A common complication of prostatitis is impotence.

Gonorrheal epididymitis occurs with redness and swelling of the scrotum, swelling and pain of the affected appendage, feverish condition. As a result of illness into the ejaculatory duct appear to scarring, which eventually leads to infertility.

In women, gonorrhea can often occur without any symptoms. Sometimes patients report unusual discharge from the vagina and the urethra or pain during urination. Without proper treatment, the disease can spread into the uterus and fallopian tubes, causing pain in the lower abdomen.

Diagnosis of gonorrhea

Despite the typical clinical symptoms, the diagnosis of gonorrhea, the doctor can put only after carrying out special laboratory tests. However, before this specialist is a history of the disease, the use of physical methods of research. These include:

· The survey

· General inspection of patients

·Palpation of the abdomen

· Visual inspection of the external genitalia

· Inspection with the help of mirrors

· Bimanual gynecological examination

In the survey, the doctor usually finds out from the patient if he was having casual sex, does the woman intrauterine contraception, how she had abortions. Visual inspection of the genital organs determine the presence of edema and hyperemia of the mucosa of the urethra, purulent discharge. The purpose of bimanual examination is to identify signs of inflammation of the uterus, appendages and peritoneum of the pelvis.

Laboratory methods include the following list of tests:

· General analysis of urine

· General blood analysis (white blood cell count, shift formula to the left)

· Analysis of blood group and RH factor

· Biochemical analysis of blood

· Bacterioscopic analysis of the smear (white blood cells, gonorrhea and their intracellular location, paint smear by Gram various colours)

If there are indications additionally appointed:

· Culture (bacteriological) method study

· Enzyme-linked immunosorbent assay

· PCR

· The reaction of immunofluorescence.

The treatment of gonorrhea

In the treatment of gonorrhea, the emphasis is on antibiotics that have a direct effect on the gonococci. As additional therapy is applied topical treatment, immunotherapy, physiotherapy. Unfortunately, doctors are not always the first time to succeed, because recently there has been an increase in resistance of gonococci to antibiotics penicillin. The reason for the failure can also be a mixed infection and immunopathology.

The who-recommended treatment for gonorrhea is third generation cephalosporins.

In acute gonorrhea enough etiotropic treatment (eliminating the cause of the disease), through which it is possible to achieve a stable therapeutic effect. The treatment of torpid (oligosymptomatic) gonorrheal process is best to start with a provocative and not antibacterial agents, in connection with what is prescribed gonovaccine scheme.

If antibiotic therapy has not led to a cure, then a second course of antibiotics is carried out after determination of sensitivity of strains to other drugs.

If mixed infection, for example, acute gonorrhea and Trichomonas, antibiotics for treatment are determined simultaneously. If gonorrhea chronic or torpid forms complicated by trichomoniasis, beforetreatment with antibiotics is used in immunotherapy.

When combined with gonorrhea or chlamydial infection ureplazmennaya recommended to use antibiotics, active against all these pathogens. Your drug is chymotrypsin (a proteolytic enzyme) appointed by parenteral injection at a dose of 10 mg.

When you add Candida infections the appropriate use of such antifungal drugs like nystatin, fluconazole, ketoconazole, natamycin. Because antibiotics kill not only pathogenic, but also useful microflora during treatment of any form of gonorrhea is additionally a good idea to drink Bifiform, a Canadian yogurt, Laktobakterin. However, remember that all prescription medications should only be done by a specialist, self-treatment contraindicated and fraught with complications. Besides, during the treatment of gonorrhea, patients should refrain from sexual relations and strictly adhere to the diet (restricted to eating fatty, spicy, smoked food).

In addition to used therapeutic and physical therapy, and this:

· UHF-therapy

· Mud therapy

· Ultrasound

· Diathermy

· Ionophores (with a 5% solution of calcium chloride and 1-2% solution of sodium iodide).

8-10 days after the last drug intake, patients pass validation tests. In the absence of objective and subjective symptoms, persistent negative cultural and microscopic studies therapy can be considered successful. Bacteriological culture and laboratory investigations are usually conducted after 24; 48 and 72 hours after the combined provocations of men, and during menstruation in women.

If the response to the negative gonorrhea and show no symptoms of inflammatory processes, re-examination is carried out 3 times, after which patients are removed from the register with good performance.

Prevention of gonorrhea

Personal prevention of each person for the prevention of gonorrhea involves the careful selection of sexual partners, condom use in casual sexual intercourse, urination and washing Miramistina or warm water with soap genitals after a casual relationship, regular examination by specialists, especially in the first two hours after sexual contact.