Gonorrhea( gonorrhea) - Causes, symptoms and treatment. MF.

Gonorrhea( gonorrhea) is a venereal disease that affects the mucous membrane of the urogenital organs, less often the oral mucosa, rectum, conjunctiva. It was described 3,5 thousand years ago in the "papyrus of Ebres", then in the second century of our era Galen gave the name "gonorrhea" for the first time, which is translated as "spermatozoanie."In his work he pointed out the difference between this state and the eruption of the seed during erection. Detection of the causative agent is the merit of Albert Neisser. He isolated it from the pussy of the urethra and the conjunctiva. In honor of him was named and causative agent of gonorrhea - gonococcus Neiser.

The causative agent of gonorrhea

The gonorrhea of ​​Neisser is the causative agent of gonorrhea. Gonococcus is like a bean, folded concave sides inside. It is not drained in the external environment, but it is very steady inside the body. This is due to a protective capsule, which protects the gonococcus from the action of immunoglobulins( substances that protect our body from microbes).

Another feature of the causative agent of gonorrhea is the production of beta-lactomase, which reduces the effects of antibiotics taken to naught. These most beta-lactam strains are most often responsible for the chronic course of the disease and numerous complications.

Gonorrhea transmitted

Gonorrhea is transmitted sexually, can also be transmitted during delivery from mother to the fetus. Infection occurs in addition to sexual contact, also with oral and anal connections. When the genitals are only in contact, without the introduction of the penis into the vagina, gonorrhea infection is also possible. Women "pick up" gonorrhea from men almost in 100% of sexual intercourse with the patient.

Gonococci can also be introduced into the reproductive organs of girls by the mother's contaminated hands, towels, sponges, bed linens.

Symptoms of gonorrhea

The incubation period of gonorrhea( from the moment of infection until the onset of the first symptoms) lasts from 2 to 7 days. Sometimes it can be delayed up to 2 - 3 weeks, this is facilitated by taking antibiotics in the wrong dose for gonococcus, a decrease in immunity, which in our time period is not uncommon. Getting on the mucous membrane of the urethra, gonococcuses reproduce on its cells. Then they penetrate into the intercellular space, causing a strong inflammatory reaction.

The course of the disease is divided into acute and chronic. It is believed that the acute form of gonorrhea lasts 2 months, and then chronic. But this conditional division. Each person has his own peculiarities of an orgasm, his own immune system, etc. So it is possible that the infection "will penetrate too far" much earlier, especially if there was or is a history of prostatitis( inflammation of the prostate gland in men), inflammation of the appendages in women. Therefore with the first symptoms of gonorrhea immediately contact the dermatovenereologist .

Symptoms of gonorrhea in men and women due to anatomical and physiological characteristics are somewhat different:

Symptoms of gonorrhea in men

In men, the gonorrhea starts with burning and itching, especially during urination. When pressing on the head, a droplet of pus stands out. The head of the penis and the foreskin are inflamed.

Discharge from the penis with gonorrhea

When the infection enters the back of the urethra, frequent urination occurs. By the end of this act, a drop of blood can join. In the process, quite often, inguinal lymph nodes with their inflammation and enlargement are involved.

If gonorrhea is not treated, the process extends to the entire urethra, prostate, seminal vesicles, and testes. Appears painful, frequent, difficult urination. The temperature may rise, chills occur, pain during defecation.

Symptoms of gonorrhea in women

Women in the initial stage of gonorrhea are usually involved in the urethra, vagina, endocervix( cervical canal).With inflammation of the urethra will be itching, painful and frequent urination, and with inflammation of the vagina and endocervix - purulent discharge, soreness, including during sexual intercourse. If there is an infection of pus on the external genitalia, often their inflammation( vulvitis) with the corresponding symptoms occurs.

Unfortunately, the female symptoms are not as pronounced as in the stronger sex, 50-70% of women with gonorrhea do not have any unpleasant sensations, and often we diagnose gonorrhea in chronic form. That's why you need to listen to your body, and even with the slightest change, you need to see a doctor. Later, seeking medical help with asymptomatic gonorrhea leads to the fact that the disease passes from the cervix to the uterine mucosa, fallopian tubes, ovaries. There is a risk of ectopic pregnancy, infertility, complications during childbirth.

Separately distinguish ascending gonorrhea, when the infection immediately penetrates into the bladder, the prostate gland, appendages in its acute course.

Gradually the symptoms subsided, a period of imaginary well-being appears and the gonorrhea passes into a chronic form that is characterized by a mass of complications, which I will discuss later.

Gonorrhea in pregnancy

Infected with gonorrhea is possible both during and before pregnancy. Unfortunately, the disease can be asymptomatic( without pain in the lower abdomen, secretions), but can lead to premature birth, miscarriage and intrauterine infection, especially in girls. It is extremely dangerous infection with gonococcal mucous eyes( children's blenorea), leading to blindness. That's why, after giving birth, 30% of sodium sulfacyl is instilled in all the children at once. A few days after birth, the child's eyes turn red, yellow or green discharge begins. It is necessary to immediately consult a doctor and begin treatment to prevent damage to the cornea and all tissues of the eye leading to blindness.

Extragenital forms of gonorrhea

Extragenital forms of gonorrhea are presently occurring. Most often this is due to non-traditional sexual contacts

1) Gonorrhea of ​​the rectum .The rectum becomes infected with anal connections and the drift of pus into it. As a rule, it proceeds secretly or itchy in the anus and a painful act of defecation.

2) Gonococcal pharyngitis, tonsillitis ( inflammation of the mucous throat, tonsils) is a marker of oral connections. Usually does not cause anxiety or there may be a slight soreness when swallowing. This is also dangerous for this condition, since the person remains infectious until the appropriate treatment is prescribed. In the people there is an erroneous opinion about the safety of oral caresses .Here to you and my answer to this. ..

3) Gonococcal lesions of the eyes ( adult blenorrhea) - may be the result of spreading the infection or drifting the pathogen through dirty hands. In this case there will be a purulent discharge from the eyes, lacrimation. As the process spreads, all this ends in partial or total blindness.

Analgesia for gonorrhea

Differential diagnosis of gonorrhea is performed with other urogenital infections, which can also be combined with gonorrhea. And for this you need to go to the doctor's office with a morning urine retention( best of all), otherwise with 3 hours delay. A smear in men is taken from the urethra, in women from the vagina, endocervix, urethra. If there were extragenital sexual relations - scraping from the pharynx, rectum. The material is looked under a microscope or sown on nutrient media. It is also necessary to be screened for other STDs( syphilis, AIDS, hepatitis B, C, trichomoniasis, chlamydia, mycoplasma, ureaplasma).A combination of trichomonads and gonococci is common.

Treatment of gonorrhea

The first antibiotic for the treatment of gonorrhea was penicillin and a group of penicillin antibiotics, but in this time period gonococci appeared resistant to it, and they do not act on hidden infections( mycoplasmas, ureaplasma) that can be "obtained with a gonorrhea".

Currently widely used fluoroquinolones( abaktal), tetracycline series( unidox), macrolides( summed, josamycin).In chronic and complicated gonorrhea, the appointment of immunomodulators( gonovaccine, pyrogenal), resorptive treatment( lidase), biostimulants( aloe), topical treatment( Instillations in the urethra of myramistin solution, as well as vanochles), physiotherapy on the prostate, appendages, ovaries( UHF,ultrasound).

During the treatment of gonorrhea, the use of alcohol and sexual intercourse is strictly forbidden. Sexual relations only after complete control. The daily toilet of the genitals is necessarily shown with warm water with soap and changing of underwear. When using tetracycline antibiotics, avoid exposure to the sun, as they increase the sensitivity of the skin to ultraviolet light and can simply be burned.

It is imperative to undergo control after treatment of gonorrhea, even if you feel well. Controls in men and women are carried out 7-10 days after the end of the course of antibiotics. Take smears for microscopy and sowing after provocation( prick of a gonovaccine or pyrogenal).Further men have the same algorithm in 2-3 weeks, in women during 2 - 3 menstrual cycles.

Effective treatment of gonorrhea appeared only in the era of antibiotics and therefore the use of folk remedies is a direct way to complications.

Complications of gonorrhea

Complications are very diverse:

The most common complications are gonorrheal prostatitis, orchitis and adnexitis, ooritis( inflammation of the prostate, testicles in men and appendages and ovaries in women).The consequence of this is infertility, as in these organs scar tissue is formed. As a result, the quality of the seminal fluid and the difficulty of sperm penetration to the egg and the egg itself suffer.

Urethral stricture - narrowing of the urethra due to the formation of the same scar tissue, leading to a violation of urination and ejaculation.

Gonorrheal phimosis and paraphimosis( partial or complete obstruction to open or close the glans penis).The cause is the infection of the external and internal leaf of the prepuce in men. Especially dangerous is paraphimosis, since the head is compressed, the blood circulation is disturbed, followed by necrosis( tissue death).

In advanced cases, generalization of infection is possible: gonococcal peritonitis( inflammation of the peritoneum), arthritis( inflammation of the joints), sepsis( blood infection).

Summarizing this, I will say: "Gonorrhea can be a fatal disease."

Prevention of gonorrhea

As I wrote in previous articles about STDs, the most reliable prevention is a monogamous relationship. Condoms save from gonorrhea, but do not give 100% guarantee, although if they do exist in your life, they can not be neglected in any way. It is also necessary to show the toilet of the external genital organs with warm water with soap + washing the urethra with a solution of chlorhexidine, miramistine. Women use candles "Hexicon", pharmatex. If there are several sexual partners, it is necessary to undergo an examination every year from a urologist / gynecologist, even if there are no symptoms of the disease.

It should be added that gonorrhea is the most common venereal disease in Russia, it is much more common than syphilis. It, like, however, and syphilis, you can get sick several times. Many, unaware that they are sick, continue to live sexually, infecting their partners, are not treated, and the disease progresses, leading to serious complications.

Consultation of a doctor for gonorrhea:

Question: Is it possible to diagnose gonorrhea by donating blood from a vein?
Answer: Such works were conducted, but at the moment there. Only a general swab and sowing.

Question: Can I get gonorrhea in the pool?
Answer: No. Gonococci are unstable in the external environment.

Question: Does it mean that casual oral communication should be in a condom?
Answer: Yes. Necessarily + subsequent prevention, as I wrote above.

Doctor dermatologist, venereologist Mansurov A.S.