Gonorrhea in the eyes of newborns, children and adults - treatment and prevention
Mar 05, 2018
Gonococcal conjunctivitis refers to severe eye damage that can lead to complete blindness. At the moment, gonorrhea of newborns is the exception rather than the norm. It occurs only in cases when the pregnant woman did not undergo examination in a woman's consultation and was an infected gonorrhea.
Infection with gonorrhea infants occurs at a time when the head is moving along the birth canal. Microorganisms from the mucous membrane of the mother easily penetrate the baby's conjunctival sac, causing a specific inflammation. In addition to the visual analyzer, the genital organs of girls can also become infected during childbirth. In boys, infection of the genital organs does not occur due to the peculiarities of their anatomical structure.
Gonorrhea occurs in children and adults. The main way of transmission in this case is contact-household, with it there is a "rubbing" of the diplococcus into the eye mucosa. This way of infection is possible if the person does not observe the basic rules of hygiene and does not wash his hands after visiting the toilet. Also skidding of the infection in the eyes can occur through common towels, bath accessories, bed linen.
In the generalization of the gonorrheal process, which is observed with a decrease in immunity and a long-term disease, the microorganisms are scattered throughout the body, with the blood flow of Neisseria( the causative agent of gonorrhea) can enter the sensory apparatus and cause there a specific inflammation.
How the gonodrenorrhea
manifests The incubation period in the disease is approximately 2-5 days from the time the source of infection enters the body.
With any route of infection, edema and redness of the eyelids occur. They become compacted, painful when touched. After a few days, initially a scanty, later more abundant serous-purulent discharge, sometimes with an admixture of blood, appears. At a time when there is a profuse suppuration, the swelling of the eyelids somewhat decreases. The secret withers in the form of dirty-green crusts and prevents the eyes from opening.
Because of the purulent discharge of the epithelium, the cornea becomes loosened, macerated, it is easy to develop ulcers, which subsequently disrupt the integrity of the cornea and form coarse scars or thorns. All these factors lead to the fact that the eye sharply loses its visual acuity, up to complete blindness.
In adults, gonorrheal conjunctivitis is more severe, with increased body temperature and fever, and joint surfaces of the extremities may also be involved in the process.
Symptoms of gonorrhea in children and adults have some differences. For example, in children and newborns, the disease affects both eyes simultaneously, but adults are more likely to have unilateral infection. In neonates, gonoblenaore is less often accompanied by corneal involvement and common intoxication.
Prevention of gonorrhea
For the prevention of gonoblennorrhea, all newborns are injected three times with a few drops of 20% albucid in each eye, and girls are also buried in the genital cleft.
Before delivery, every pregnant woman is repeatedly examined for venereal diseases and, in case of pathology, mandatory treatment is performed. However, in cases where a woman did not register and at the same time was a carrier or had gonorrhea, it is much more difficult to prevent the birth of a patient with gonorrhea. For this purpose, a preventive course of antibacterial therapy is carried out - penicillin, erythromycin, tetracycline, chainin, ciprofloxacin. Of these, sterile solutions are prepared, which wash the eye gap of the newborn.
Preventive therapy with ceftriaxone was shown to be highly effective once. To prevent the spread of infection throughout the body, the same ceftriaxone is used, but according to the scheme - once a day or ceftriaxime twice a day, both for a week.
How the gonoblenorea
is treated The treatment of gonoblennorei is divided into general and local, with both types of therapy being carried out simultaneously.
The treatment of gonoblenaire is primarily aimed at preventing the involvement of the second eye in the process. To do this, a healthy eye in the first hours after birth or from the time of the onset of clinical symptoms is often instilled with a sterile solution of penicillin or potassium permanganate in a dilution of 1: 5000( pale pink color).The eye is isolated with a sterile hermetically sealed dressing.
Local treatment also includes washing the eye gap with warm freshly prepared solutions of furacilin in a dilution of 1: 5000, boric acid( half a teaspoon per glass of warm water).Irrigating eyes with benzylpenicillin( 5-10 thousand units), 20-30% with albucid, 0.3% with tsipromedom, 20% with sodium sulfacil, 0.25% with levomycetin every 2-3 hours are also performed.
In addition to medicines, you can additionally use for eye washing broths of herbs - chamomile, calendula, oak bark, sage.
For the night must always lay eye ointment for eyelids. For this purpose, the most suitable is tetracycline ophthalmic ointment, floxal, tobrex, dexa-gentamicin.
If there is a strong eyelid edema or corneal ulceration occurs, it is necessary to instill every 2-3 hours with a solution of pilocarpine or scopolamine. Also instillations of eyes are made with saline solution and ceftriaxone or ceftriaxone is administered parenterally. Naturally, the treatment is not only the patient, but also his immediate relatives, with whom he lives.
Local therapy should be carried out for at least 2 weeks, until the eyes calm down and the risk of inflammation passing to a healthy eye disappears.
General methods of treatment
As for general treatment, it is directed to fight with the pathogen( gonococcus), to increase the overall resistance of the body. The treatment regimens for children, adults and newborns differ only in dosages.
Adult treatment regimens are applied to children weighing over 40 kg:
- ceftriaxone 125 mg once;
- Spectinomycin at 40 mg per kilogram of body weight once;
- Doxycycline is 100 mg twice daily for a week.
As a stimulant, designed to increase the amount of antibodies to the pathogen, use gonovaccine. It is indicated to children over 3 years old for the diagnosis of disease cure and as a therapy for antibiotic-resistant, chronic forms of gonorrhea. The first dose of the drug is 0.05-0.1 ml once every 1-2 days. The dose is gradually increased to 0.5 ml, and then gradually reduced. In total it is necessary to make 8 injections.
In addition to injecting drugs, it is possible to use tableted antibiotics - ampicillin, oxacillin, augmentin.
- Ampicillin takes 7-14 days 1-2 tablets three times a day.
- Oxacillin is taken in the same scheme, always 1 hour before meals, for 5 days. The drug has a great activity in relation to diplococci and to it the resistance of pathogens is produced much more slowly.
- Augmentin has a bacteriolytic effect on gonococci. In acute course, it is prescribed for 5 days, 1-2 tablets 3 times a day.
But still the best way to avoid gonorrhea of the eyes is to follow preventive measures, timely treatment of the disease in the initial stages and use of protective equipment during sexual intercourse.