Gonorrhea in children and adolescents, is everything to blame Venus?

The WHO Department of Reproductive Health is alarmed by the spread of gonorrhea. Not only does this disease have a high prevalence among all layers of the population, in addition known antibacterial drugs cease to have an effective effect on the causative agent of gonorrhea - gonococcus Neisseria. This leads to an increase in the number of sick men and women, and, accordingly, children.

Gonorrhea has always been one of the curable venereal diseases, but lately it has ceased to be so in the broad sense of the word because of the developed resistance of the human body to many antibiotics. In connection with this, cases of not only chronic course of the disease and asymptomatic carriage, but also the birth of children with gonorrhea became more frequent.

Gonorrhea in children can occur in several ways. To them carry - a household way, infection during passage through patrimonial ways of a sick mother and sexual way. Very rarely are cases of hematogenous way of infection of the fetus through the mother's blood.

Gonorrhea of ​​newborns

In case of infection during childbirth, the conjunctival sac of the eyes suffers first, in this case a disease called gonoblenorea - acute gonococcal conjunctivitis develops. To prevent this pathology, all newborns are instilled with 30% Albucidum. However, during childbirth outside the medical institution, or if the pregnant woman is not registered in a women's consultation and is sick with gonorrhea, infecting the babies is still possible.

Gonoblennaya usually affects both eyes simultaneously and without treatment in a large percentage of cases leads to blindness. Symptoms of conjunctivitis develop several days after the birth of the child and are manifested in the form of swelling and hyperemia of the eyelids. Appears initially lean, then abundant purulent discharge, eyes stick together, which makes it impossible to open the eyelids for inspection. Gonococci penetrate into the deeper tissues of the eyeball, affecting the cornea, which eventually leads to a thinning and a sharp decrease in vision.

In girls, in addition to the conjunctiva of the eyes during childbirth, the vagina can also become infected. This is particularly easy with the breech presentation of the fetus. Therefore, all newborn girls in addition to the eyes are buried a few drops of albucid and the sex slit.

If a gonorrhea appears in a pregnant woman on the eve of delivery to protect a newborn from infection, a caesarean section is produced.

Gonorrhea disease in girls

In addition to infection during childbirth, young girls can become infected with household items or through the hands of a sick mother who is not particularly demanding of her own hygiene. In these cases, infection occurs in the genital tract of the child and the characteristic symptomatology of the gonorrheal process develops.

Gonorrhea, as a rule, affects the vulva, urethra and vagina. Involvement in the process of the uterus and fallopian tubes is a rare phenomenon. But lesions other than genital organs of the rectum, is relatively common.

Symptoms of gonorrhea in girls appear sharply and painfully. There is pain in the genitals and urethra, it increases with walking and with tight hip reduction, so many girls are forced to lie with their legs dilated widely. Urination becomes more frequent, pain occurs during defecation. Cases of gonorrhea proceeding against the background of high body temperature, weakness, feelings of weakness are not uncommon.

On the part of the genitals there is swelling, hyperemia, secretion of a purulent secret in large amounts, which, drying up, leaves dirty green crusts on the skin around the genitals. The external opening of the urethra is also hyperemic, edematic, the mucous membrane protrudes out of it in the form of an inflamed cushion, a purulent secret is secreted from the canal.

If the ampoule of the rectum and the anus are involved in the process, then there are clear signs of inflammation, purulent discharge, soreness, itching and burning. In severe process, erosion occurs in the anus. Purulent discharge irritates the skin of the perineum, there are signs of dermatitis.

After a while, even without treatment, the symptoms subsided, pain decreases, the mucous becomes pale pink, the secret from the genitourinary organs and the anus becomes less abundant. Nevertheless, despite the external stagnation of the process, pressing the genitals from the vagina appears pus. Also, signs of defeat can be present in the Bartholin glands - swelling, red-cyanotic compaction, tenderness in palpation.

If the process is left untreated, it will necessarily go into a chronic phase, when the periods of exacerbation will be replaced by fading of the process, in this form the disease can last for many years, but inevitably lead to complications.

Gonorrhea in older girls can occur not only when infected through household items, but also at the early onset of sexual activity without the use of protective equipment.

The incubation period averages about a week, but it may also lengthen due to the frequent use of antibacterial and sulfanilamide preparations for other diseases.

In children and adolescents, several stages of the disease are distinguished - acute( in different variations of the clinical course) to several months and chronic, its duration can be months or even years. Frequently ill children carry an acute form of the disease with minimal signs, and their disease often turns into a chronic form.

Adolescents and mixed infections are often found when gonorrhea adjoins trichomonads, chlamydia, mycoplasmas, syphilis. Mixt infections significantly change the clinical course of the disease, which leads to a later referral to the doctor.

Symptomatic of gonorrheal process in girls does not look so terrible, in comparison with adults, but nevertheless, complications after gonorrhea they are sometimes more formidable. Girls may have a menstrual cycle, various abnormalities in the process of gestation and childbearing, including infertility or stillbirth.

Gonorrhea disease in boys

Gonorrhea in boys during labor almost never affects the genitals. The same goes for the domestic way of infection - due to the peculiarities of the structure of the genital organs for boys, this way of transmission is not inherent. But the sexual way in boys is the main one.

This causes inflammation of the urethra, foreskin, glans penis( balanoposthitis), and later develops phimosis. The skin of the preputial sac( the skin fold between the inner leaf of the foreskin and the glans penis) turns red, swells, and thickens. Extreme flesh does not move away, which greatly complicates intimate hygiene, from under it begins to emit a purulent secret. Micturition not only increases, but also brings a lot of painful sensations, burning, itching.

In the morning, there may be a symptom of a "morning drop" - the release of a small amount of purulent exudate after sleeping. In addition, there may be painful nocturnal erections that are not associated with a sexual object. In the case of chronic course of the disease, the process can pass to the testes and appendages, seminal vesicles, prostate.

Treatment of gonorrhea in children

Without treatment, gonorrhea can lead to the following complications:

1. Urinary tract and kidney infections;
2. Violation of the menstrual cycle;
3. Infertility and non-gestation, stillbirth;
4. Increased likelihood of syphilis, chlamydia, papillomatosis, ureaplasmosis, HIV;
5. When infecting infants in childbirth - various eye diseases, up to blindness.

That is why early diagnosis and during the treatment begun in childhood and adolescence are of paramount importance.

In an acute stage, gonorrhea treatment in children begins with mandatory strict bed rest in a hospital setting, and in the chronic form of the disease, outpatient treatment is allowed.

In essence, the treatment of gonorrhea in children differs from similar therapy in adults only by dosages of medications.

Newborn infants born to infected mothers receive preventive therapy with ceftriaxone once. To prevent the spread of infection throughout the body, the same ceftriaxone is used, but according to the scheme - once a day for a week or ceftriaxime twice a day.

With gonoconjunctivitis, instillations of the eyes are made with saline and ceftriaxone or ceftriaxone is administered parenterally. Naturally, the treatment is not only a sick child, but also his parents.

In relation to children weighing more than 40 kg with uncomplicated gonorrhea, adult treatment regimens are used:

1. ceftriaxone 125 mg once a day
2. Spectinomycin at 40 mg per kilogram of body weight once
3. Doxycycline is 100 mg twice daily for a week.

As a stimulant, designed to increase the amount of antibodies to the causative agent, use gonovaccine. It is indicated to children over 3 years old for the diagnosis of disease cure and as a remedy for antibiotic-resistant, lethargic and 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.

As a local therapy, warm sessile baths or microclysters are assigned to the urethra with broths of herbs - chamomile, sage, marigold, oak bark, willow or protargol syringing. In addition, with proctitis, microclysters are produced with the broths of these same herbs. Sedentary medicinal baths must be done several times a day. Observance of intimate hygiene during treatment should be strictly carried out.

When the proctitis develops, the anus is lubricated with Mikulich's ointment, miramistin, propoceum. In general, the ointment with gonorrhea has a regenerating and epithelizing effect. You can make ointment bandages on the anus, and lubricate the rectum.

In conclusion, I would like to emphasize again the importance of preventive measures:

• Mandatory hygiene;
• Children at any age should sleep separately from their parents;
• A child should be given a separate towel for the hands and face, legs, as well as for the genitals;
• Older children and adolescents need to explain possible ways of getting infected with sexually transmitted diseases, their consequences and possible protection measures.