Gonococcal infection (gonorrhea) Gonorrhoea, Gonococcal Infection is an infectious disease caused by Neisseriagonorrhoeae, sexually transmitted with a predominant lesion of the human genitourinary system.
Causes
The causative agent of gonorrhea is gonococcus. In most cases, gonorrhea (gonococcus) is transmitted sexually. In most cases, gonorrhea is transmitted through sexual contact, mainly after casual sex without using a condom.
Infection with gonorrhea occurs through all kinds of forms of sexual intercourse: during normal sexual intercourse, during oral-genital intercourse, during anal intercourse, and simply through contact of the genitals, without insertion of the penis into the vagina.
In some cases, infection may occur by everyday means, for example, through household items: bed linen, underwear, washcloth, towel, etc. This route of infection is mainly typical for the female half of the population and especially for girls.
Gonorrhea symptoms
The incubation period for gonorrhea can range from 1 to 15 days. But usually the first signs of gonorrhea appear 3-5 days after infection.
Acute urethritis is the most common manifestation of gonorrhea in men. Usually incubation period takes from 2 to 7 days, although it can last longer. The main symptoms are urethral discharge and dysuria. The discharge may initially be scanty and mucous, but after a day or two it becomes profuse and purulent. These severe and obvious manifestations distinguish gonococcal urethritis from non-gonococcal urethritis, which can be caused, for example, by chlamydia. Men with asymptomatic urethritis are the main reservoir for the spread of infection. In addition, they and those who leave the disease untreated are at greater risk of developing complications.
Diagnostics
Even if the described symptoms of gonorrhea are present, diagnosing the disease and making an accurate diagnosis is only possible in the laboratory. Usually a smear is taken from the urogenital tract and examined for the presence of gonococci.
Types of disease
There are two forms of gonorrhea:
1. The fresh form is when the duration of the disease does not exceed 2 months from the moment of the first manifestation clinical signs gonorrhea. In turn, in the fresh form phase there are:
- acute gonorrhea,
- acute gonorrhea
- torpid gonorrhea, characterized by minor symptoms of the disease, lasting no more than 2 months.
2. The chronic form is a sluggish process of gonorrhea lasting more than 2 months or with an undetectable duration of the disease.
Patient Actions
If you have the described symptoms, be sure to consult a doctor.
Treatment of gonorrhea
If you suspect gonorrhea, do not self-diagnose or self-medicate under any circumstances. Gonorrhea is a very serious disease that leads to serious consequences when improper treatment- when the first signs of the disease appear, immediately contact a venereologist, urologist or gynecologist.
If you have gonorrhea, you must strictly observe the rules of personal hygiene; after visiting the toilet, be sure to wash your hands with soap. Men should not squeeze pus from the urethra - this can cause the infection to spread.
When treating gonorrhea it is recommended drinking plenty of fluids and exclusion of spicy foods, alcohol and beer from the daily diet. It is not recommended to visit the pool, ride bicycles and exercise bikes, as well as large physical exercise and long walking.
Antibiotics are prescribed to treat gonorrhea. The most effective are mucrolides, fluoroquinolones and cephalosporins. Premature termination of treatment is unacceptable; it is necessary to complete the full course of treatment, because even with the first improvements and disappearance external signs gonorrhea pathogen (gonococcus) remains in the body and the disease develops into chronic form. It is recommended to re-examine after a course of treatment.
Complications
When gonococci enter the human body, they infect the mucous membranes of the urethra, cervix and anus, causing their purulent inflammation. Untreated infection can be ascending and spread into the uterus, fallopian tubes and pelvic cavity in women, and in men it can cause damage to the epididymis. In addition, gonorrhea can lead to ectopic pregnancy, development adhesive process V abdominal cavity and persistent masculine and female infertility. Complications such as inflammation of the rectum (proctitis) and eyes (gonorrheal conjunctivitis) are also possible. Very rarely, serious complications such as the spread of infection through the bloodstream and damage to the heart, joints or brain are observed. If a newborn is infected from a sick mother during childbirth, inflammation of the conjunctiva of the eyes (blenorrhea) and the development of blindness in the newborn are possible.
Gonorrhea prevention
It is necessary to examine, and if the disease (signs of gonorrhea) is detected, treatment of all persons who have had sexual contact with a patient with gonorrhea. It is also necessary to examine girls if even one of the parents becomes ill.
Using a condom is the most reliable method of preventing infection from both gonorrhea and other venereal diseases sexually transmitted diseases.
With gonorrhea, there is no immunity and, if you are careless, repeated infections with gonorrhea are possible.
After sexual intercourse without a condom, you should immediately urinate and wash the external genitalia with warm water and soap (preferably household soap). In this way, you can wash off any gonococci that have gotten on them. Within 2 hours after sexual intercourse, special antiseptics in the form of solutions are used for prevention - gibitan, cidipol, miramistin and others. They destroy gonococci and pathogens of other sexually transmitted diseases infectious diseases. However, do not forget that these remedies are not 100% effective, and it decreases as the period of time from sexual intercourse increases.
– specific infection, caused by the gram-negative microorganism Neisseria gonorrhoeae and affecting the mucous membrane of the genitourinary tract, rectum, oral cavity, and pharynx. The genitourinary form appears purulent discharge from the vagina with unpleasant smell, dysuria, nagging abdominal pain, itching and soreness in the area of the external genitalia, but may also be asymptomatic. Methods for diagnosing gonorrhea in women include examination on a chair and laboratory research(microscopy of smears, culture of secretions, PCR, PIF). Etiotropic antibiotic therapy is carried out with cephalosporins, penicillins, and fluoroquinolones.
Causes of gonorrhea in women
The pathogen that causes gonorrhea, Neisseria gonorrhoeae, is a bean-shaped, gram-negative, aerobic diplococcus. Inside the human body, the pathogen is highly resistant, external environment dies quickly. The pathogenicity factors of gonococcus are: capsule with antiphagocytic activity; villi, with the help of which the bacterium attaches to the epithelium; endotoxin secreted by the cell wall; membrane proteins with pronounced antigenic properties.
With the help of surface proteins, gonococci attach to columnar epithelial cells, causing their death and desquamation. They are phagocytosed by polynuclear neutrophils, within which they retain viability and ability to reproduce. Typically, gonococci initiate specific local inflammation, but when they enter the bloodstream they can cause disseminated gonococcal infection. Quite often, gonorrhea in women occurs in the form of a mixed infection: gonorrheal-chlamydial, gonorrheal-trichomoniacal, gonorrheal-mycoplasma, gonorrheal-candidiasis.
The predominant route of infection is sexual, infection is possible through unprotected vaginal, oral-genital or anal-genital contact. Multifocal, multiple organ lesions are often encountered. The non-sexual route of infection can occur during childbirth as the child passes through the birth canal. Extremely rarely observed domestic infection– mainly in case of close contact of a child with a mother who has gonorrhea (for example, in the case of sharing a bed, towels, hygiene items, etc.).
Factors contributing to the high prevalence of gonorrhea among women include: low level general culture, early start sexual activity, numerous sexual relationships, neglect of barrier methods of contraception and spermicides during casual sexual contacts, prostitution. The rise of infection is facilitated by childbirth, intrauterine interventions (probing of the uterine cavity, abortion, RDV), menstruation, and poor intimate hygiene.
Classification of gonorrhea in women
Depending on the duration of the disease, fresh (lasting up to 2 months) and chronic (lasting over 2 months) gonorrhea in women is distinguished. Taking into account the severity of symptoms, the fresh form can have an acute, subacute or torpid course. Chronic infection, as a rule, is asymptomatic, with periodic exacerbations. In the absence of specific local manifestations, but the pathogen is isolated in scrapings from the mucous membranes, they speak of a latent infection, or gonococcal carriage.
There are genital and extragenital forms of gonorrhea in women. According to the localization principle, gonorrhea of the lower parts of the genitourinary tract (urethritis, paraurethritis, vestibulitis, bartholinitis, cervicitis) and gonorrhea of the pelvic organs (endometritis, salpingitis, adnexitis, pelvioperitonitis) are differentiated. The course of gonorrhea in women can be uncomplicated or complicated.
Symptoms of gonorrhea in women
Gonorrhea of the lower genitourinary tract
The incubation period for lesions of the lower genitourinary tract averages 5-10 days (with ascending, disseminated gonorrhea and estrogenital forms it can increase). In almost half of infected women, gonorrhea is asymptomatic or minimally symptomatic. Local manifestations depend on predominant defeat of one or another organ, however, gonorrhea in women often occurs in a mixed form. The classic signs of the disease are the appearance of abundant vaginal discharge white or yellowish color with an unpleasant odor. This sign is often regarded by a woman as a manifestation of nonspecific vaginitis or thrush, and therefore attempts are made self-treatment infections that erase the true clinical picture.
Gonorrheal urethritis. To defeat urinary tract indicates frequent urination, accompanied by a feeling of burning and stinging, imperative urges, sensation incomplete emptying Bladder. Upon examination, the external opening of the urethra is swollen and hyperemic, painful on palpation; when pressed, a purulent discharge appears from it. Complications of gonorrheal urethritis with ascending spread of infection can include cystitis and pyelonephritis.
Gonorrheal bartholinitis. Bartholin's glands in gonorrhea in women are affected secondarily due to the leakage of pus from the urethra or cervix. When the excretory duct is blocked, the glands become inflamed, increase in size, and become sharply painful—a Bartholin gland abscess is formed. In advanced cases, the abscess can spontaneously open with the formation of non-healing fistulas, from which there is a constant flow of pus.
Ascending gonorrhea
Gonorrheal endometritis. This clinical form of gonorrhea in women occurs with liquid purulent-serous or sanguineous discharge from the genital tract, dull pain in the lower abdomen and back, and low-grade fever. As a result of disturbances in the proliferative and secretory transformation of the endometrium, menstrual disorders such as hyperpolymenorrhea may be observed; sometimes acyclic uterine bleeding occurs. When purulent contents are retained in the uterine cavity, the clinical picture of pyometra develops.
Gonorrheal salpingitis and salpingoophoritis. Develops when damaged fallopian tubes and ovaries, is often bilateral. The acute phase of gonorrhea in women manifests itself with fever and chills, aching (sometimes cramping) pain in the lower abdomen. When soldering both ends fallopian tube(uterine and ampullary) it is possible to form hydrosalpinx, and then pyosalpinx, and in the case of inflammation spreading to the ovary - pyovar, tubo-ovarian abscess. Against the background of an extensive inflammatory process in the pelvis, a pronounced adhesive process is formed.
Gonorrheal pelvioperitonitis. This form of gonorrhea in women is caused by the spread of infection from the fallopian tubes to the pelvic peritoneum. Pelvioperitonitis of gonococcal etiology manifests itself rapidly: sharp pains in the lower abdomen with irradiation into the epigastrium and mesogastrium, symptoms of muscle protection. The temperature quickly rises to febrile levels, vomiting, gas and stool retention are noted. Peritonitis rarely develops, since the rapid formation of adhesions limits inflammatory process from the abdominal cavity.
Complications of gonorrhea in women
The danger of gonorrhea lies not only in high degree infectiousness and diversity clinical forms, but also in frequent development complications, both for the woman herself and for the offspring. Thus, gonorrheal endometritis often causes uterine infertility in women, and gonorrheal salpingitis and salpingoophoritis - tubal infertility and ectopic pregnancy.
Gonorrhea in pregnant women can provoke spontaneous abortion and premature birth; cause delay intrauterine development and antenatal fetal death, intrauterine infection of the fetus with the development of gonoblenorrhea, otitis, gonococcal sepsis of the newborn; postpartum purulent-septic complications in a woman in labor.
With disseminated gonococcal infection, skin lesions, gonorrheal tenosynovitis, arthritis, hepatitis, myopericarditis, endocarditis, meningitis, pneumonia, osteomyelitis, and sepsis may occur. Asymptomatic gonorrhea in women does not guarantee the absence of complications.
Diagnosis of gonorrhea in women
Genital forms of gonorrhea in women are usually diagnosed by a gynecologist or venereologist; extragenital forms can be detected by a dentist, otolaryngologist, ophthalmologist or proctologist. The history, as a rule, contains indications of casual sexual intercourse or multiple sexual contacts. In typical cases, examination on a chair reveals the flow of ribbon-like mucopurulent discharge from the external os of the cervix, signs of vulvovaginitis. During a vaginal examination, a slightly enlarged, painful uterus, a conglomerate of fallopian tubes and ovaries fused together may be palpated.
In order to confirm the diagnosis, material is taken from the vagina, cervical canal, urethra, rectum, oral cavity, conjunctiva (depending on the location of the primary focus). Laboratory diagnostic tests include microscopy of smears with Gram staining, culture of discharge for gonococcus, examination of scrapings using PCR and PIF. Serological studies(RIF, ELISA, RSK) do not allow differentiating previously suffered and current gonorrhea in women, therefore they usually do not play a decisive role in diagnosis.
If latent or chronic gonorrhea is suspected in women, when the pathogen is not detected in scrapings, use various methods provocations: chemical (lubrication of the urethra and cervical canal with protargol solution), mechanical (urethral massage), biological ( intramuscular injection pyrogenal or gonovaccine), thermal (physiotherapy - ozokerite therapy, paraffin therapy, UHF, etc.), nutritional (consumption of spicy, salty foods, alcohol), physiological (menstruation). After provocation, biological material is collected three times: after 24, 48, 72 hours.
Treatment and prevention of gonorrhea in women
When prescribing therapy, the form, location, severity of manifestations of gonorrhea in women, the presence of concomitant infections and complications are taken into account. The basis of therapy is a course of antibiotic therapy with drugs of the penicillin, cephalosporin, and fluoroquinolone series. When gonorrhea is combined with chlamydia or trichomoniasis, metronidazole or doxycycline is added to therapy.
For fresh gonorrhea in women, occurring with damage to the lower parts of the genitourinary tract, a single dose or administration of an antibiotic (ceftriaxone, azithromycin, ciprofloxacin, cefixime) is sufficient. The course of treatment for ascending gonorrhea or mixed infection is extended to 7-10 days. The treatment of chronic gonorrhea in women includes immune stimulants, autohemotherapy, and the administration of a gonococcal vaccine. Local treatment includes washing the urethra with 0.5% silver nitrate solution, washing the vagina with antiseptics (solutions of potassium permanganate, chlorhexidine, miramistin). Treatment of the sexual partner is a mandatory measure. After the inflammatory process subsides, physiotherapeutic procedures (UVR, electrophoresis, UHF) are prescribed.
For complicated forms of gonorrhea in women (tubo-ovarian abscess, pyosalpinx, etc.) it is indicated surgery- removal of appendages. In case of development of pelvioperitonitis, laparotomy is necessary to sanitize the abdominal cavity. In case of an acute suppurative process in the area of the Bartholin gland, the abscess is opened, the wound is washed and drained.
When identifying a woman with gonorrhea, it is necessary to examine family members or sexual partners. For personal prevention purposes, it is recommended to use condoms during casual sexual contacts. After unprotected sexual intercourse, you should contact a medical facility as soon as possible for emergency STI prevention. Screening for gonorrhea is a mandatory part of the pregnancy management program and annual gynecological examination women. Health education plays an important role in the prevention of gonorrhea.
Gonococcal infection or, in other words, gonorrhea is a fairly common venereal disease transmitted during unprotected sexual contact. Very often the development of this disease is accompanied by damage to the genitourinary system.
Statistics show that over the past 15 years, the number of cases of gonorrhea has decreased significantly. But despite this, about 62 million people face gonococcal infection every year. This disease poses the greatest danger to young girls under 25 years of age. This is due to the excessive rapidity of development of inflammatory processes in the pelvic area in such individuals, leading to infertility.
Gonorrhea ranks second among sexually transmitted diseases in terms of importance and prevalence. Only chlamydial infection is ahead of it.
Causes of gonorrhea
Most often, cases of gonorrhea infection can be observed in people leading an immoral lifestyle. Every casual sexual contact without using a condom can result in the development of this problematic disease. The causative agent of gonococcal sepsis is gonococcus.
You can become infected with gonococcal infection through any unprotected sexual contact:
- During normal sexual intercourse;
- With oral-genital contact;
- During anal sex;
- With a simple touch of the genitals, even without penetration of the penis into the vagina.
There is also a possibility of infection due to sharing hygiene or household items with a sick person. Such items could be:
- Bed sheets;
- A bath towel;
- washcloth;
- Underwear.
This method of infection is more typical for women than for men.
Expectant mothers should be especially careful with gonococcal infection. A child born to an infected girl will also face this fate. In addition to a sexually transmitted disease, the baby will have serious vision problems, and may even go blind. More than half of cases of congenital blindness in infants are caused by gonorrhea.
Symptoms of gonorrhea in men
The most early signs A patient can experience gonococcal infection within 3-5 days after unprotected sexual intercourse with a sick person. In rare cases, the disease may not appear for up to two weeks.
A characteristic manifestation of the development of gonococcal sepsis in men is acute urethritis, which can usually be observed 3 days after infection. In very rare cases, symptoms may not appear for about 10 days. The most important sign of gonorrhea is urethral discharge and dysuria. The very first discharge has a mucous structure, but after a couple of days it will become purulent and its quantity will increase significantly.
It is worth noting that in some men, urethritis may be asymptomatic. It is these representatives of the stronger sex who are the most dangerous carriers of gonococcal infection.
Manifestations of gonococcal sepsis in women
The nature of the manifestation of gonorrhea in the fair sex is much more diverse and may include the following symptoms:
- Gonococcal cervicitis
- Gonococcal vaginitis.
- Anorectal gonorrhea
It should be noted that this disease can be caused not only by gonococcus; its development can also be provoked by chlamydia and other pathogenic bacteria.
The main symptom of gonorrhea in women is specific vaginal discharge. In addition, pain in the lower abdomen may also occur.
If a woman has this disease, then any examination will bring her a lot of discomfort. This is due to extreme swelling of the vaginal mucosa and the presence of copious purulent discharge.
The essence of this disease is the development of gonococcal infection in the rectum.
Diagnosis and treatment of gonorrhea
Even if all the above symptoms of the disease are present, a conclusion about the presence or absence of gonorrhea can only be made after laboratory analysis. Most often, a smear of the urogenital tract is examined for the presence of gonococcus.
If the first signs of gonorrhea are detected, the patient should under no circumstances self-medicate. The first thing to do is contact to a good doctor venereologist or gynecologist.
Gonorrhea is very dangerous disease, which could lead to dire consequences. That is why you must strictly follow all the specialist’s recommendations. Men need to squeeze the pus out of the urethra to prevent the infection from spreading.
Treatment of gonorrhea involves following a special diet, which requires:
- Drink a large number of liquids;
- Eliminate spicy foods from your diet;
- Quit alcohol and smoking.
Gonococcal infection is an infectious disease that is most often transmitted during sexual intercourse from an infected person to a healthy person. The gonococcal environment affects genitourinary system, and then manifests itself in the form of many other secondary symptoms. The resulting disease is called gonorrhea or gonorrhea.
If a patient is diagnosed with gonococcal infection, he requires immediate treatment.
The microorganisms that cause the infection are Neisseria gonorrhoeae. If you look at them under magnification, they have the shape of beans, folded side by side with the concave sides inward. In the external environment, the bacterium quickly dies, but in the human body it can remain for quite a long time.
The thing is that they are surrounded by a special protective capsule that prevents them from interacting with human immunoglobulin. The duration of treatment is also explained by the fact that gonococci produce beta-lactamase, which neutralizes the effect of most modern antibiotics.
Once in the body, gonococci “live” inside cells, namely, in leukocytes. Probability of infection for women is 50-70%. This figure rises to 90% if constant sexual partner women are infected with gonorrhoea. A man who has had several contacts with a sick partner has a risk of infection of up to 80%.
Etiology
In medicine, there are several ways that gonococcal bacteria enter the patient’s body. The very first is unprotected or casual sexual contact with an infected person. Infection is possible during any act: anal, oral or vaginal.
The next method of transmission is infection of a child who, during childbirth, passes through the genitals of a mother who has gonorrhoea. Microorganisms are highly likely to enter the newborn’s body.
Infection is also possible in domestic conditions (through hygiene items, towels, dirty linen). But in medicine, such cases are recorded quite rarely.
Symptoms in men
Symptoms of gonorrhea in men are as follows:
- burning in the genital area.
- itching, which becomes severe if left untreated.
- inflammatory process on the head of the penis and foreskin.
If you press lightly on the head, a small amount of pus will be released from the urethral canal. If the gonococcal pathogen reaches the back of the urethra, then urination becomes frequent, during which the patient feels pain. At the end of the urination process, it is possible bleeding. Secondary symptom is inflammation lymph nodes V groin area, they enlarge and become inflamed.
Gonococci are pathogenic microorganisms whose infection requires immediate treatment. If you do not go to the hospital in time, the inflammatory process will spread to the urethra, prostate, seminal glands and testicles.
Symptoms in women
The main signs of infection are extensive damage to the uterus and its cervix, urethra, and vagina. Symptoms depend on how severely affected female organs disease. Inflammation in the urethra leads to, accompanied by. If the cervix and vaginal tissue are inflamed, then discharge with pus is characteristic, nagging pain in the lower abdomen. When the infection settles on the external genitalia, it develops.
Danger of this disease for women is that in 50% of patients its initial stage is asymptomatic. The woman does not feel discomfort, but at the same time she is a carrier of the infection and needs medical treatment. Gonorrhea enters an advanced stage, causing damage to the fallopian tubes and ovaries. In the future, this may provoke difficult childbirth or even.
Diagnostics
The studies that gynecologists use today are the following:
- Collecting the patient's medical history. To get an overall picture of a person’s health, the doctor must know the presence chronic diseases in the reproductive system, pathologies that occurred during pregnancy, if any, condition genitourinary organs permanent partner.
- Visual inspection of the external genitalia. With its help, you can identify the inflammatory process, swelling or hyperemia of the urethral mucosa, pathological character discharge.
- Examination on a chair using a special mirror. Thus, inflammation in the uterus, vagina, and atypical discharge are detected.
- Gynecological examination of a bimanual nature for the presence of inflammation of the appendages and uterus.
A laboratory test will be prescribed by a doctor if the patient has the following indications:
- diagnosis of infertility.
- pathological course of pregnancy, miscarriage or.
- the presence of acute or chronic urogenital infections.
- detection of urogenital diseases in a sexual partner.
If there is a suspicion of gonorrhea, then all diagnostic steps should be followed:
- bacterioscopic examination of discharge (smear for Trichomonas and gonococci);
- culture to detect sensitivity to antibiotic drugs.
To identify gonorrhea, a detailed analysis of secretions collected from the urethra () is most often used. The probability of detecting gonococci in a smear in men is about 90%. Gonococci are detected in a smear in women in only 60% of cases. Therefore, such research alone is not enough. In parallel, other, more accurate diagnostic methods are performed.
A smear taken from the genital organs can be bacteriological or bacterioscopic. A bacterioscopic type analysis is performed by staining a smear with a chemical solution of methylene blue. A rapid reaction occurs, during which colored gonococci are clearly visible on the laboratory glass, standing out against the background of other cells.
With 95-100% accuracy, gonorrhea in women is diagnosed by culture of secretions. Biomaterial is collected from the urethra, vagina, oral cavity(pharynx), rectum, cervix. To obtain reliable result, a minimal amount of material is sufficient. This research lasts up to 7 days. By analyzing the culture of vaginal secretions, it is also possible to establish the sensitivity of the internal microflora to various antibiotics. This is very important for subsequent treatment of gonococcal infection.
Analysis transcript
There are only two possible results:
- positive – gonococci were found in the examined material;
- negative - deciphering the test for gonococcus completely excludes the presence of Neisser's gonococci.
It is necessary to take into account the fact that a negative indicator may be the result of incorrect sampling of material or unqualified performance of micro-research. A false answer is possible if the patient has undergone a course of antibiotic therapy in the current month.
Treatment
Treatment of gonococcal infection is a long process that consists of a set of medical prescriptions. Initially, the disease was eliminated with the help of penicillin-containing drugs. But modern strains of gonorrhea have become resistant to this component. Treatment regimens have changed. Now the infection is treated with drugs of the tetracycline group, macrolides, and fluoroquinolones. Antibiotic therapy is performed according to a regimen that the doctor prescribes individually for each patient. Under no circumstances should you self-medicate or exceed the prescribed dosage.
If a person is diagnosed with chronic gonorrhea, then it is advisable to inject the gonococcal vaccine. Vaccination is effective auxiliary when implementing therapeutic therapy. It is prescribed to patients from 3 years of age. If all other types of therapy have failed, then the doctor’s last recommendation will be this vaccination.
To increase the body's defenses, patients are prescribed treatment with biostimulants, immunomodulatory agents, baths with weak solution miramistina.
During the treatment period, the patient is strictly prohibited from sexual relations, consumption alcoholic drinks. Preferably during acute phase observe bed rest.
Prevention
The only one preventive measure is the exclusion of casual sexual contacts. If you have a new partner, then be sure to use. After intimate intercourse, thoroughly clean the genitals with soap and warm water.
Gonorrhea is a sexually transmitted disease. It can occur in both men and women. The infection is often asymptomatic, which entails late treatment. medical care and development serious complications, including infertility. The causative agent of the disease is gonococcus (Neisseria gonorrhoeae). In everyday life you can hear another name for gonorrhea - “grip”.
Despite the fact that in recent decades there has been significant progress in the treatment of infection, gonococcus is gradually becoming resistant to modern antibacterial agents. Therefore, if the regimen for taking them is violated, gonorrhea may become chronic. Having been ill once, a person can become infected again and again.
Although susceptibility is the same in both sexes, after the first intimate contact with a patient, every second to fourth man and every fifth to seventh woman become infected with gonorrhea. In the vast majority of cases (70-80%), simultaneous infection with chlamydia, trichomoniasis and other STDs occurs.
Show all
1. Manifestations of gonorrhea in women
Due to the anatomy and physiology gonococcal infection in women it often occurs almost unnoticed or has very few symptoms.
Bacteria can affect not only the mucous membranes of the genitourinary organs, so the symptoms of gonorrhea may differ in different women. It depends not only on the route of infection, great importance also have a fortune immune system, presence of chronic diseases.
1.1. First symptoms
The first signs appear immediately after the end of the incubation period, which for a woman can range from 3 days to 1 month, but usually does not exceed two weeks. They can be pronounced or weak. Typically, when infected during vaginal intercourse, the following symptoms are observed:
- Vaginal discharge of white, white-green, green, gray-white color (mucous and mucopurulent, copious, viscous).
- Urinary disorders (frequent painful urination, increased frequency of trips to the toilet, burning and itching in the urethra).
- Nagging pain in the lower abdomen.
The general condition may not suffer: body temperature does not rise, weakness, chills do not occur.
1.2. Damage to the genitourinary system
First of all, gonococci cause inflammation in urethra, vestibule of the vagina and inside it, paraurethral and Bartholin's glands.
The most common signs of gonococcal urethritis, vulvovaginitis, cervicitis:
- Intense or moderate pain at the end/beginning of urination, quite sharp.
- Enlarged inguinal lymph nodes.
- Pain and discomfort during sexual intercourse.
- Gonorrhea discharge is abundant or scanty, mucopurulent, thick, gray-green, yellow-green, gray-white with an unpleasant odor.
- Frequent, painful urination.
- Swelling and redness of the urethral opening, vulva, vaginal walls, and with endocervicitis - the cervical area.
An inflammatory process may occur in the Bartholin glands with the development of an abscess. They are round formations with a diameter of 1-2 cm and are filled with pus. When the infection spreads to the overlying sections and pelvic organs, endometritis, adnexitis, and pelpioperitonitis develop.
1.3. Gonococcal pharyngitis
Infection of the pharyngeal mucosa occurs mainly during oral sex. Gonococcal pharyngitis often occurs latently.
The following symptoms may be observed:
- Feeling of dryness and pain when swallowing, soreness.
- Hoarseness of voice.
- Enlargement of the submandibular lymph nodes.
- Redness of the throat area.
- Purulent plaque on the tonsils, their redness and increase in size.
- Bad breath.
- Possible inflammation of the gums and oral cavity (gingivitis, stomatitis).
1.4. Proctitis
Infection occurs during anal sex, as well as when vaginal discharge flows into the anus. The disease manifests itself:
- 1 Itching and burning in the anus.
- 2 Constipation, false painful urge to defecate.
- 3 Periodic purulent discharge from the anus, sometimes mixed with blood.
- 4 Going to the toilet becomes more frequent and brings discomfort.
2. Gonococcal conjunctivitis
Gonococcal eye infection can occur at any age and occurs as inflammation of the iris (iridocyclitis) or conjunctiva (conjunctivitis).
Most often this is associated with infection through dirty hands, as well as through shared use of hygiene items, including towels. Separately, blenorrhea (gonococcal ophthalmia) of newborns is distinguished when a child becomes infected when passing through birth canal mother.
Symptoms:
- Severe swelling of the eyelids (they become swollen).
- Photophobia - increased sensitivity to the bright light.
- Purulent discharge, which usually accumulates in the corners of the eye, on the eyelashes.
- Redness of the conjunctiva, increased bleeding.
In advanced cases, corneal ulcers appear, perforation occurs, and blindness develops.
3. Gonorrhea of other organs and systems
Sometimes gonococcal infection occurs with damage to the joints - arthritis, joint capsules (bursae) - bursitis, bone tissue– osteomyelitis.
Gonorrheal arthritis is characterized by inflammation of a small number (two to three) large joints, and subsequently - persistent limitation mobility until the development of ankylosis. Bursitis and osteomyelitis have a typical course.
Gonococci enter other distant organs through the bloodstream due to the weakening of the body's defenses. In this case, classic diseases develop:
- myocarditis, endocarditis;
- meningitis;
- pneumonia;
- brain abscess;
- sepsis and so on.
4. Features of mixed infection
IN last years often observed atypical course gonorrhea against the background of simultaneous infection with gonococcus, chlamydia, mycoplasma, trichomonas, etc. In this case, the classic symptoms of gonorrhea fade into the background. Mixed infection is more difficult to treat and more often becomes chronic.
4.1. Chlamydia
Against the background of chlamydia, the incubation period of gonorrhea is often extended to three months. Mixed chlamydial-gonococcal infection has a tendency to chronic course, difficult to cure after the first course of antibiotics, as a rule, requires the use of provocative techniques.
Trichomonas are single-celled microorganisms that can “disguise” as human cells and “evade” the immune system.
Another property of them is to penetrate deep into the tissues of the host. Gonococci are capable of quite long time to be inside Trichomonas and “hide” from unfavorable environmental conditions.
Simply put, prescribing antibiotics may not be effective. Gonococci existing inside Trichomonas survive and then begin to actively reproduce.
For this reason, a combined infection (gonorrhea + trichomoniasis) tends to have a long, wave-like course with high risk chronicity.
Its symptoms depend on the state of the body and the depth of the inflammatory process:
- 1 When good immunity– low-symptomatic course, the presence of scanty discharge with an unpleasant odor, pain or simply a feeling of discomfort during sexual intercourse or urination.
- 2 When the defenses are weakened - pain when urinating, foamy, mucopurulent discharge with an unpleasant odor, discomfort, pain and slight bleeding are observed during sexual intercourse.
Gonorrhea can also be combined with diseases such as syphilis, genital herpes, HPV infection, HIV, candidiasis and others.
5. Diagnosis and treatment
If any warning symptoms appear, you should undergo comprehensive examination for STDs.
As a rule, for this purpose a smear is necessarily taken for microscopic examination(for flora and GN), and is also carried out comprehensive analysis, which detects the DNA of the main pathogens of sexually transmitted infections using the polymerase method chain reaction(PCR, real-time PCR).
The doctor prescribes treatment based on the results obtained. The scheme must include one or more antibacterial drugs. All sexual partners are treated at the same time. Otherwise, therapy will be useless.
The drugs of choice that are most effective for gonorrhea are:
- Ceftriaxone;
- Cefixime;
- Cefotaxime;
- Spectinomycin.
Most often, treatment for gonorrhea is offered on an outpatient basis; only pregnant women, children, as well as women with complications and requiring further examination are hospitalized.
2 weeks after the end of the course of antibiotics, repeat tests are performed (NASBA - detection of gonococcal RNA in scrapings). PCR method can be used no earlier than 30 days after the end of therapy.
Gonorrhea is considered cured when the result is twice negative. If the therapy is ineffective, alternative antibiotics are prescribed after culture with sensitivity determination.
Loading...