Gonorrhea (gonorrhea) – specific infectious-inflammatory
a process that affects mainly the urogenital system, the causative agent
which are gonococci (Neisseria gonorrhoeae). It is also possible
defeat of the conjunctiva, pharyngeal mucous membranes, rectum. With
gonorrhea does not cause immunity that prevents recurrence
What is this disease, the causes, and what
The first signs in adults and treatments are most effective.
Gonorrhea: what is it?
Gonorrhea is a sexually transmitted sexually transmitted disease.
way and proceeding with lesions of the cylindrical epithelium
Gonorrhea is more common among young people between 20 and 30 years old, but
can occur at any age. Very great danger
complications of gonorrhea – various urogenital disorders (including
including sexual), infertility in men and in women. Gonococci can
penetrate into the blood and, circulating throughout the body, cause:
- joint damage,
- sometimes gonorrheal endocarditis and meningitis,
- severe septic conditions.
It is proven that the prevalent route of transmission of gonococcal infection
– sexual contact. 50-70% of women get an infection after the first
contact, among men, the infection rate of 25-50%.
Causative agent гонореи — гонококк – Neisseria gonorrhoeae.
Causative agent гонореи вольготно себя чувствует только в
nutrient media, especially if there is a native (not modified)
human protein, and in the man himself. In its external environment
Gonococci die in seconds in ordinary soap
solution, quickly die under the action of even weak antiseptics
(silver salts, betadine, alcohol and others), die as they dry
mucus and pus in which are found. This feature is very useful.
for humans and is used as a prophylaxis for gonorrhea.
Gonococci mainly infect the lower urinary tract.
systems that are covered with cylindrical epithelium.
- These are the mucous membranes of the paraurethral glands and the urethra – in
- urethra, cervical canal, fallopian tubes, Bartholin glands –
women. Vaginal walls are covered with stratified squamous epithelium, in
norm it is immune to gonococci. The development of gonorrheal vaginitis
occurs when loosening of the epithelium during pregnancy, in
puberty or menopause.
There are genital and extragenital (not sexual) gonorrhea.
Genital gonorrhea is characteristic of genital gonorrhea.
The group of extragenital gonorrhea includes:
- gonorrhea anorectal localization (direct inflammation
- gonorrhea of the bone and muscular systems (gonorrheal arthritis),
- gonorrheal damage to the conjunctiva of the eye (gonoblina),
- gonorrheal defeat of the pharynx (gonococcal pharyngitis).
The course of the disease is divided into fresh, chronic and
Fresh gonorrhea is considered if
the first clinical signs of the disease have passed no more than 2 months.
During this period, the body actively struggles with developing
gonococcus, which determines the clinical picture
There are 3 forms:
- With острой форме больной ощущает в полной мере все
the above symptoms. It does not take longer than 14
день после infection. The urethra reddens, swollen.
Allocation abundant. The patient begins to feel chronic fatigue,
fatigue, severe headache.
- With подострой форме симптомы не слишком выражены, но они есть.
Gonococcus in the body causes only rare and scant discharge
yellow color. Other signs are completely absent.
- The most dangerous is torpid or asymptomatic form.
gonorrhea. The patient does not bother. Subjective signs
there is no disease. The person is a carrier of gonococcus, and
unaware of it.
Chronic gonorrhea is the result of advanced fresh gonorrhea,
arising from inadequate treatment or lack of therapy.
The latent form of the disease is characterized by almost
бессимптомным течением и чаще встречается у women. In this case
the patient is infected, that is, is the carrier and source
infections, but his immune system for one reason or another does not
reacts to an alien microorganism, resulting in
the inflammatory process does not develop and subjective sensations
(symptoms) are absent.
У мужчин даже при скрытой форме гонореи могут наблюдаться
certain non-specific signs (gluing of the sponges of the urethra
after a night of sleep, the appearance of a small amount of muddy
discharge from the urethra after a long walk, run or session
For gonorrhea, there are no differences by gender and
social status, as well as its victim can become as small
child and adult.
According to statistics from the World Health Organization, every year
this insidious disease strikes about a quarter billion population
This is because the pathogen is different
highly resistant to certain drugs, and
it is also not the last role in the spread of infection
social reasons and behavioral factors
(the prosperity of homosexuality, prostitution and the growth of promiscuous
Gonorrhea can be caught by:
- unprotected sexual intercourse (oral, vaginal, anal
- sharing with a patient shared towel, linen,
- children become infected with gonococci during childbirth;
- girls may get sick if they are not keeping the urinary hygiene
organs (potty gonorrhea);
- gonococci are brought into the eyes by the hands (arises blenorrhea);
- gonorrhea can also be brought about in a household way.
dirty hands in the mouth (gonorrheal pharyngitis, stomatitis).
Gonorrhea as an infection has a high level of contagion,
sexually transmitted (99 out of 100 cases), and only 1 case out of
100 are household infections through the patient’s personal belongings and objects.
hygiene (towels, washcloths, etc.), as well as infecting a child
Incubation period гонореи очень сильно зависит от пола
sick Incubation in women, as a rule, takes place much
longer, comes to a month or more. In turn, men period
incubation is mostly 2-5 days.
The incubation period of gonorrhea is greatly influenced by
the place where the pathogen has got. The terms described above are
valid if the organ targets for gonococcus are
Until a certain time, bacteria-pathogens do not
discover. However, after falling into a favorable environment
they begin an active breeding process that in the initial stages
the course of the disease gradually leads to the development of inflammatory
process in these bodies.
With the onset of the first clinical signs of gonorrhea
an infected person becomes a patient. Ending
the incubation period may be indicated by the appearance of the following
- burning sensation and purulent discharge from urinary organs
- swelling of the genitals;
- urination becomes frequent and is accompanied
- an increase in the inguinal lymph nodes;
- possible increase in body temperature.
With заболевании гонореей на увеличение инкубационного периода
The following factors may influence:
- taking medications especially antibiotics;
- household transmission, although rare, and mostly
The following factors affect the decrease:
- chronic diseases: tuberculosis, diabetes mellitus.
- combination of gonorrhea with other venereal pathologies:
chlamydia, mycoplasmosis, bacterial vaginitis;
- low immunity;
- alcoholism, drug addiction, smoking.
Symptoms of gonorrhea in adults
The first symptoms of gonorrhea appear 2-5 days after contact.
with a sick partner. A patient with gonorrhea feels discomfort in
urethra, later appear:
- purulent discharge yellowish-green color.
Urethral discharge first scanty, gray
colors. After 1-2 days, purulent, abundant, thick,
yellowish-green highlight colors that stain laundry.
Often gonorrhea has an atypical clinical picture due to the fact
that it forms on the background of a secondary infection. In this case
mixed infection somewhat changes the incubation period than
делает проблематичной правильную диагностику и соответственно
адекватное лечение gonorrhea. As a result, it is often formed
chronic form that is already diagnosed by having
Gonorrhea in women can manifest itself:
- Abundant purulent or mucopurulent secretions of the urethra,
worse in the morning after sleep.
- Inflammatory changes in the vestibule of the vagina (redness,
swelling and soreness of the mucous membrane).
- Itching, burning, or soreness in the urethra,
increasing at the beginning of urination or during sexual intercourse
of the act.
- Increase in body temperature to 37 – 38 degrees.
- It begins with burning and itching, especially during
- With надавливании на головку выделяется капелька гноя.
- The glans penis and the foreskin are inflamed.
- With проникновении инфекции в заднюю часть уретры появляются
учащенные urination. К концу этого акта может
join a drop of blood.
- In the process, quite often, inguinal lymph nodes are involved with their
inflammation and increase.
If gonorrhea is not treated, then the process extends to the whole
urethra, prostate, seminal vesicles, testicles.
Appears painful, frequent, difficulty urinating.
|Among women||Inflammation of the mucous membrane:
Inflammation is possible:
To finally determine the presence of gonorrhea, the presence
clinical symptoms are not a key indicator, since
laboratory detection of gonococci is necessary
- microscopic analysis of smears taken from the surface
- seeding the bacteria removed from the material taken in specific
nutrient media in order to highlight the culture of gonococci;
- PCR and IFA-diagnostics.
Self-treatment of gonorrhea is unacceptable, it is dangerous
the transition of the disease to the chronic form, and the development of irreversible
body lesions. All genders are subject to examination and treatment.
partners of patients with symptoms of gonorrhea who had sexual intercourse with them
contact for the last 14 days, or the last sexual partner, if
contact occurred earlier than this date. In the absence of clinical
symptoms of a patient with gonorrhea examine and treat all genital
partners in the last 2 months.
It is necessary to adhere to a number of rules:
- do not self-medicate (change the dosage of prescribed
drugs or even refuse to take pills);
- completely stop all forms of sexual intercourse, including
including oral caress, kisses;
- refuse to accept alcohol even
- after going to the toilet, wash your hands with soap and treat them
- use only your personal hygiene items not
- wash the clothes of the patient, especially underwear, separately from
Acute complicated gonorrhea of the lower and upper genitourinary
The system is treated for a long time. Antibiotic change in a maximum of 7
days, or prescribe drugs long courses – until disappearing
symptoms plus another 48 hours.
- Ceftriaxone 1.0 ip (intramuscularly) or intravenously (intravenously), x 1
per day, 7 days.
- Спектиномицин 2,0 в/м, х 2 per day, 7 days.
- Cefotaxime 1.0 in / in, x 3 per day or Ciprofloxacin 0.5 in / in, x
2 per day – until the symptoms disappear + 48 hours.
After stopping acute manifestations of gonorrheal inflammation
(the temperature should return to normal, the discharge is scarce or not
determined, no acute pain, local swelling decreased)
continue to use antibiotics.
The success of gonorrhea treatment depends on the correct choice.
antibiotic, dosage and duration of its reception. With
antibiotic intolerance prescribed sulfonamides. Parallel
if necessary, in the treatment scheme include:
- means of immunotherapy,
- local preparations (ointments, gels, pastes),
- as well as physiotherapy (UHF, baths).
It is important not to stop treatment after the onset of investment, because
that in this case, the gonococcus is not completely eliminated, but simply
goes into a latent form and proceeds chronically. With этом у
The causative agent can develop resistance to antibiotics.
Chronic gonorrhea is treated much longer. At first
Gonovaccine is administered in courses of 6-8-10 intramuscular injections and
drugs that stimulate non-specific immunity
(pyrogenal, ribonuclease) and only after this therapy
At the end of the course, after the disappearance of all the characteristic
symptoms of the disease, the patient spend several control
surveys using various types of provocations.
Mandatory methods of prevention:
- The use of personal protective equipment;
- Compliance with the rules of personal hygiene;
- Use after accidental unprotected sex
special antiseptics (chlorhexidine, miramistina, etc.)
- Regular diagnosis of STDs in individuals who frequently change genital
- Mandatory medical examinations of food, children and
- Mandatory screening for gonorrhea in pregnant women.
- The sanitary and educational work of narrow specialists
among the population.
Gonorrhea is considered a dangerous disease that should be treated when
appearance of the first signs, but only under the supervision of a specialist.
Self treatment of trepper is contraindicated, because can only aggravate
course of infectious and inflammatory process.