Gonorrhea Latin name. Gonorrhea

Definition. Gonorrhea is an infectious disease caused by gonococci, which is usually transmitted sexually and usually affects the mucous membranes of the genitourinary organs, and sometimes the mucous membranes of the oral cavity, pharynx (with orogenital contact) and rectum (with homosexual contact).

Etiology and pathogenesis. The causative agent of gonorrhea Neisseria go-norrhoeae- Gram-negative diplococcus, which is an aerobe or facultative anaerobe. He looks like two

"coffee beans" folded with their concave sides facing each other. Gonococcus has dimensions of 1.25 µm in length and 0.7 µm in width, a three-layered outer wall, a cytoplasmic membrane, a cytoplasm containing a nuclear vacuole and ribosomes. In some strains (30-40%), microorganisms are surrounded on the outside by a polysaccharide capsule, which protects them from phagocytosis by leukocytes. This explains the incompleteness of phagocytosis and the phenomenon of endocytobiosis, characteristic of gonorrhea. In addition, gonococci are capable of forming L-forms, which have pronounced multiresistance to antibiotics.

The route of transmission of infection is usually sexual, and with a single contact with a partner, the infectivity is about 30%. Extrasexual infection can occur in girls when they wash their genitals with sponges contaminated with the secretions of mothers with gonorrhea, when they share a chamber pot, bed, etc. Gonococci affect the mucous membranes of the urethra, vagina, rectum, oral cavity, and conjunctiva , which is observed, for example, in a fetus passing through the birth canal of a sick mother, or in a patient with gonorrhea as a result of infection of the eyes with contaminated hands. The lesions they cause are acute purulent in nature, leading to a chronic inflammatory reaction of tissues resulting in fibrosis.

The incubation period is usually 3-5 days, but can range from one day to 3 weeks or more. Immunity is not formed during gonorrhea, so reinfections, including multiple ones, are possible.

Clinical picture. Gonorrhea manifests itself in fresh and chronic forms. The disease is no more than 2 months old - this is fresh gonorrhea, which can be acute, subacute and torpid (sluggish, asymptomatic). With a longer course of the disease, a diagnosis of chronic gonorrhea is made.

Attention should be paid to the great difficulties in detecting gonococci in patients with chronic gonorrhea. This is possible only after repeated research, with the help of provocations, and sometimes only in crops.

Gonorrhea in men. Fresh gonorrhea is characterized, first of all, by inflammation of the urethra - fresh gonorrheal urethritis. Acute urethritis is characterized by cutting pain during urination, swelling and hyperemia of the sponges of the external opening of the urethra, and copious purulent discharge. Inflammatory process or limited to the anterior part of the urethra

(anterior urethritis), or extends to its posterior part (total urethritis). Anterior urethritis is characterized by pain at the beginning of urination, while total urethritis is characterized by pain at the end of it. Patients with total urethritis also suffer from frequent uncontrollable urge to urinate. With subacute urethritis, all these symptoms are less pronounced, and the manifestations of torpid urethritis are limited to scanty mucopurulent or mucous discharge (sometimes only in the morning or when squeezing out), sticking of sponges in the morning, sensations of itching or tickling when urinating. Sometimes with torpid gonorrhea there are no clinical symptoms.

In order to establish the localization of the inflammatory process in the urethra, a two-glass urine sample is used. The patient releases urine alternately into two glasses. In acute anterior urethritis, the pus is washed away with urine into the first glass, so the urine in the second glass will be clear. With total acute urethritis, the urine will be cloudy in both glasses. In patients with torpid urethritis, the urine is only slightly cloudy (opalescent) or transparent, but with purulent threads and flakes settling to the bottom: in the first glass - with anterior urethritis, in both - with total urethritis.

Chronic gonorrheal urethritis Its clinical picture resembles fresh torpid. However, it is characterized by the following features:

1) development in the urethra of infiltrates, granulations, strictures, inflammation of the glands, epithelial metaplasia and other lesions detected by urethroscopy, bouginage, urethrography;

2) periodic exacerbation of the inflammatory process with the appearance of symptoms of acute or subacute urethritis;

3) the occurrence of complications such as inflammation of the prostate gland (prostatitis), epididymis (epididymitis), seminal vesicles (vesiculitis), bladder (cystitis), renal pelvis and kidneys (pyelitis and pyelonephritis), etc.

Gonorrhea in women. In most women, unlike men, gonorrhea occurs without subjective symptoms, but affects almost all parts of the genitourinary system, as well as the rectum. Distinguish gonorrhea of the lower genitourinary system(urethritis, paraurethritis, vulvitis, vestibulitis, bartholinitis, colpitis, cervicitis and endocervicitis) and ascending gonorrhea- endometritis, salpingitis, oophoritis, pelvioperitonitis.

Acute urethritis is characterized by purulent discharge from the urethra; some patients complain of pain (cutting) during urination. In chronic urethritis, it is possible to detect scant serous-purulent discharge only after massage of the urethra, which is palpable in the form of a dense cord. Just as often as urethritis, inflammation of the cervix (cervicitis and endocervicitis) occurs in patients with gonorrhea.

Diagnostics gonorrhea is based on anamnesis data, a characteristic clinical picture, confirmed by mandatory laboratory tests, for which they use both the discharge of the urethra, paraurethral ducts, cervical canal, vaginal walls, large gland of the vestibule of the vagina, and the secretion of the seminal vesicles, prostate gland, lacunae and glands of the urethra. These laboratory tests include:

1) microscopic detection of gonococcus with typical morphological and tinctorial properties (gram-negative diplococci, located in pairs and intracellularly);

2) isolation of a pure culture of gonococcus (culture method);

3) immunofluorescent and immunohistochemical methods for detecting gonococcal antigen or its nucleic acid.

Differential diagnosis carried out with other inflammatory diseases of the genitourinary system, accompanied by damage to its mucous membranes.

Treatment Gonorrhea is carried out according to the order? 415 of the Ministry of Health of the Russian Federation “On approval of the protocol for the management of patients with “Gonococcal infection” (M., 2003) and includes the use of antibiotics, immunostimulating and symptomatic agents, physiotherapeutic and surgical methods of treatment. Mandatory means general therapy are antibiotics. Currently, the most effective drugs are cephalosporins, fluoroquinolones, and aminocyclone (spectinomycin). This is due to the fact that certain strains of gonococci produce penicillinase or β-lactamase, which ensure the resistance of the latter to penicillin and its derivatives.

When treating acute localized gonococcal infection, one of the proposed drugs is used:

ceftriaxone- 250 mg once intramuscularly; ciprofloxacin- 500 mg once orally;

ofloxacin- 400 mg once orally;

spectinomycin- 2.0 g once intramuscularly;

benzylpenicillin sodium and potassium salts- initial dose of 600,000 units intramuscularly, subsequent doses of 400,000 units every 3 hours, for a course of treatment of 3,400,000 units.

When treating gonococcal infections with systemic manifestations, the following antibiotic regimens are used:

ceftriaxone- 1.0 intramuscularly or intravenously every 24 hours;

cefotaxime- 1.0 intravenously every 8 hours; spectinomycin- 2.0 g intramuscularly every 12 hours; ciprofloxacin- 500 mg intravenously every 12 hours.

Intravenous or intramuscular therapy with one of these drugs should continue for at least 7 days.

It is possible to use another treatment algorithm: the initiated therapy with one of the above drugs is continued for 24-48 hours, and when clinical symptoms resolve, they switch to oral therapy with one of the following antibiotics:

ciprofloxacin- 500 mg orally every 12 hours; ofloxacin- 400 mg orally every 12 hours.

Treatment is carried out for 14 days; extension of the duration of therapy must be strictly reasoned.

The choice of drugs is carried out taking into account anamnestic data (allergic reactions, individual intolerance to drugs and the study of gonococcus sensitivity to antibiotics, the patient’s age, etc.).

If, after 10-12 days after the end of antibiotic therapy and the exclusion of gonococci, inflammatory phenomena (discharge from the urethra, threads in the urine, etc.) persist, then these phenomena should be considered as post-gonorrheal. The patient should be examined and treatment should begin in accordance with the etiological and topical diagnosis.

In case of failure following antibiotic therapy, clinical improvement is short-lived and, as a rule, early relapses of the disease occur. 35 days (and sometimes later, within one month) after the administration of the antibiotic, discharge from the urethra intensifies and gonococci can be detected again. For late relapses

VVs, which are less common, are characterized by a sluggish, asymptomatic clinical course. Most often, relapses occur as a result of unrecognized concomitant trichomoniasis, since, captured by trichomonas, gonococci due to endocytobiosis can maintain vital activity inside them, weakly responding to antibiotics. In cases of concomitant trichomoniasis or suspicion of it, 5-nitro-imidazole preparations (metronidazole, tinidazole, ornidazole (“Tiberal”)) should be prescribed in parallel with antibiotics. "Tiberal" is used 0.5 g 2 times a day for 5 days.

In case of acute uncomplicated relapse of gonorrhea, an antibiotic from a different, previously unused group (tetracyclines, macrolides, aminoglycosides, rifamycins, cephalosporins, etc.) should be used. In patients with a sluggish, asymptomatic course of relapse, antibiotic therapy should be carried out only after local treatment.

The gonococcal vaccine is used as a specific immunotherapy, and nonspecific immunotherapy includes the use of pyrogenal, prodigiosan, levamisole, methyluracil, potassium orotate, and thymus preparations. In addition, biogenic stimulants are used (aloe extract, FIBS, vitreous).

From physiotherapeutic methods use reinfusion of one's own blood irradiated with laser light, as well as means used for the symptomatic treatment of complications (orchiepididymitis, prostatitis, adnexitis, etc.) - diathermy, inductothermy, phonophoresis, paraffin and ozokerite therapy, mud therapy.

Local treatments for gonorrhea are: daily rinsing of the urethra with solutions of potassium permanganate (1: 10,000), furacillin (1: 5000) or ethacridine lactate (1: 1000); vaginal douching with a solution of potassium permanganate (1: 8000) or chamomile infusion (1 tablespoon per 2 glasses of water); instillation of the urethra with a 0.25% solution of silver nitrate or a 1-2% solution of protargol; bougienage of the urethra with metal and elastic bougies.

For indolent (torpid) and chronic forms of gonorrhea, treatment should be comprehensive. When treating such patients, the administration of an antibiotic should be preceded by immunotherapy and local treatment. Suspected sources of infection and those who had sexual contact with patients with gono-

rhea, persons in whom gonococci are not detected must be treated according to chronic gonorrhea regimens.

Criteria for elegance. The establishment of clinical-microbiological criteria for the cure of gonorrhea is determined using clinical, bacterioscopic and bacteriological studies and is carried out 2-14 days after the end of treatment (subsequent studies are carried out according to indications). If the source of infection has been identified and the test results for gonorrhea are negative, patients are not subject to further observation. If the source of infection is unknown, a repeat serological examination for syphilis is recommended after 3 months, for HIV, hepatitis B and C - after 3 and 6 months. The bacteriological research method should be used not only for the primary diagnosis of gonorrhea, but also for monitoring cure. Bacteriological examination is necessary in the following cases:

1) when gram-negative diplococci are detected in smears suspicious for gonococci;

2) in the presence of a suspicious history and clinical picture of the disease against the background of negative results of a bacterioscopic examination for gonorrhea;

3) to diagnose and establish its cure in patients who, despite the absence of gonococci, still have inflammatory phenomena.

Anterior urethroscopy allows us to establish only the nature of inflammatory changes after the disappearance of gonococci in acute clinical manifestations of gonorrhea, which is important for prescribing appropriate local treatment. However, it is not possible to determine the gonorrheal etiology of these changes using urethroscopy.

The criteria for cure of acute complicated and chronic gonorrhea are:

1) persistent absence of gonococci (during bacterioscopic examination and culture) in urethral discharge, scrapings and urine threads;

2) no changes during palpation of the prostate and seminal vesicles, normal content (5-10 per field of view) of leukocytes in their secretion with a significant content of lipoid grains;

3) complete absence or presence of mildly expressed inflammatory changes in the urethra during urethroscopic examination.

The patient should be informed about the need to use a condom during sexual intercourse until complete recovery. All sexual partners of patients with symptoms are subject to mandatory examination and treatment if they have had sexual contact with patients in the last 14 days, or the last sexual partner is examined and treated if there was contact earlier. If a patient with gonorrhea has no symptoms, all sexual partners over the past 60 days are subject to examination and treatment. At the initial appointment, it is necessary to convince the patient to conduct tests for other sexually transmitted infections (syphilis, chlamydia, trichomoniasis, as well as HIV, viral hepatitis B and C). In order to prevent concomitant chlamydial infection if it is impossible to diagnose chlamydia, it is advisable to accompany all treatment regimens for gonococcal infection with the prescription of anti-chlamydial drugs.

gonorrhoea) is a sexually transmitted sexually transmitted disease; is caused by bacteria of the species Neisseria gonorrhoeae, which affects the mucous membranes of the genital organs of men and women. Symptoms of the disease appear about a week after infection. A person is bothered by pain during urination and purulent discharge (chronic gonorrheal urethritis (gleet)) from the urethra (in men) or vagina (in women); however, some women may be asymptomatic. If a woman develops gonorrhea during pregnancy, the infection can enter the baby's eyes as the baby passes through the birth canal (see Neonatal gonorrhea). In advanced, untreated cases, gonorrhea can spread to the entire human reproductive system and in the future cause infertility; Severe inflammation of the urethra in men can make it difficult to urinate (a condition called stricture). In later stages, the disease can be complicated by arthritis, inflammation of the endocardium, extending to the heart valves (endocarditis), and also lead to infectious eye damage, causing conjunctivitis. Sulfonamides, penicillin or tetracycline are used for treatment; these medications are especially effective in the early stages of the disease.

GONORRHEA

A sexually transmitted disease caused by gonococcal bacteria. The main symptoms in men: discharge from the penis, pain and burning sensation during urination. Infected women may not initially show symptoms, but more often have urethral or vaginal discharge, pain during urination, and sometimes lower abdominal pain; severe cases can lead to pelvic inflammatory disease, which is very painful. If left untreated, the disease can become chronic with a number of complications, including inflammation of the prostate, arthritis, and severe inflammation of the membranes of the heart.

GONORRHEA

venereal disease caused by the microbe gonococcus. As a rule, it is the result of casual sexual intercourse. Extrasexual transmission of infectious agents through household items is also possible. The first signs of G. usually appear 3–5 days after infection. Men experience heat, itching and burning in the anterior part of the urethra, which intensifies with urination. There is scanty gray discharge from the urethra, which soon becomes purulent and profuse. The process can gradually spread to the prostate gland, seminal vesicles, epididymis; severe complications are possible. In women, acute G. occurs unnoticed. Purulent vaginal discharge, itching and burning in the external genitalia and perineum, cutting pain when urinating quickly disappear. Without feeling sick, a woman continues to be sexually active, becoming a source of infection for other people. If the disease is neglected, it will spread to all human reproductive organs and may cause infertility.

GONORRHEA

venereal disease caused by gonococcus. The mucous membranes of the genitourinary organs are predominantly affected. Damage to the conjunctiva, mucous membranes of the pharynx, and rectum is also possible.

Gonococcus is a gram-negative paired coccus (diplococcus). Outside the human body, gonococci are little stable and die as the substrate in which they are located dries out; they die almost instantly in soapy water; weak solutions of antiseptic and antibacterial agents have a detrimental effect on them. In the human body, gonococci relatively quickly acquire resistance to antibiotics and sulfonamide drugs.

Gonorrhea is usually transmitted sexually from a person with gonorrhea or from a carrier of the bacteria. During sexual intercourse, gonococcus enters the mucous membrane of the genital organs and urethra and causes local inflammation in them. During anal intercourse, gonococcal lesions of the rectum may occur, and during oral intercourse, the nasopharynx may occur. Infection of the eyes in adults is rarely observed when gonococci come into contact with the conjunctiva from hands contaminated with secretions of the genitourinary organs, and in a newborn - when passing through the birth canal of a mother with gonorrhea. It is also possible for girls to become infected at home due to violation of hygiene rules (“potty” infection, use of shared personal hygiene items, etc.).

Due to the common routes of transmission of the pathogen, a mixed infection is possible, in which, in addition to gonococci, chlamydia, trichomonas, herpes viruses, etc. are found. In such cases, after the death of the gonococci, the inflammatory process can be supported by these microorganisms. Gonorrhea is often observed in patients with syphilis.

Clinical picture. The incubation period is from 1 day to 1 month, more often 2 – 4 days. Along the way, acute (fresh) and chronic gonorrhea are distinguished. In men, gonorrhea manifests itself more often in the form of urethritis, which is characterized by burning pain in the urethra at the beginning of urination, the presence of mucopurulent discharge from the urethra, hyperemia and sticking (especially in the morning) of its external opening. However, in many patients, subjective disorders (pain, burning) are mild, and the amount of discharge from the urethra is small.

Discharge from the urethra is initially scanty and gray in color. After 1–2 days, purulent, profuse, thick, yellowish-green discharge appears, which stains the laundry. Painful erections occur at night. When the process spreads to the neck of the bladder, frequent imperative urges, pain at the end of urination, and sometimes blood in the urine are observed. The general condition does not change significantly, sometimes the body temperature rises slightly, general weakness and lack of appetite are noted.

Without treatment or with improper treatment, gonorrheal urethritis becomes chronic (the infection is more than 2 months old). In this case, mild symptoms are noted - slight redness of the urethral sponges, scanty discharge, and the absence of subjective disorders. Gonorrheal urethritis can be complicated by paraurethritis, phimosis, paraphimosis, epididymitis, prostatitis, cystitis, and inflammation of the seminal vesicles. The chronic course of gonorrhea is characterized by periodic exacerbations that occur under the influence of sexual arousal, alcohol intake, spicy food, etc.

In women, gonorrhea, even in acute cases, is sluggish and unnoticeable. Almost all patients develop gonorrheal urethritis, accompanied by frequent urge and cutting pain when urinating. Purulent discharge from the vagina, itching and burning in the area of the external genitalia appear. However, these phenomena quickly pass. Without feeling sick, the woman does not go to the doctor and leads a normal life, being a source of the infectious agent. At the same time, the inflammatory process continues to spread, often affecting almost all parts of the genitourinary system. When infectious agents pass from the uterine cavity to the fallopian tubes, an inflammatory process develops in them, characterized by swelling, infiltration and thickening of the mucous membrane with the formation of adhesions and subsequent obstruction of the lumen. The fallopian tube becomes impassable for sperm and eggs, which leads to infertility. Gonorrheal salpingitis is accompanied by constant pain in the lower abdomen and lumbar region, and bloody discharge from the vagina. Menstruation is disrupted (prolonged, accompanied by pain, and becomes profuse). Chronic gonorrhea in women occurs with periodic exacerbations that occur under the influence of hypothermia, during menstruation, etc.

Girls get gonorrhea most often between the ages of 2 and 8 years. As a rule, infection occurs through household means through toilet and household items contaminated with the patient’s secretions. Usually the source of infection is the mother, less often other relatives and personnel caring for the child. Due to age-related anatomical and physiological characteristics in young girls, gonococci cause inflammation of the vulva, vagina, and urethra. The internal genital organs are extremely rarely affected. There are bright red hyperemia and swelling of the labia majora, vestibule of the vagina and perineum, profuse purulent or mucopurulent discharge from the vagina (gonorrheal vulvovaginitis). Patients are bothered by burning and itching in the area of the external genitalia, and pain when urinating.

Diagnosis of gonorrhea is carried out only on the basis of the detection of gonococci in smears or cultures. Material for microscopic examination and culture in men is taken from the urethra, during massage of the prostate gland, seminal vesicles, in women - from the urethra, cervical canal, rectum.

Treatment is carried out in a dermatovenerological clinic (outpatient or inpatient). Indications for hospitalization include complications of gonorrhea (salpingo-oophoritis, prostatitis, arthritis, etc.), relapses and reinfections of gonorrhea, as well as evasion of outpatient treatment, lack of permanent residence, chronic alcoholism and other social motives.

The results of treatment largely depend on the behavior of the patient himself. During treatment, sexual activity is prohibited. It is necessary to strictly observe the rules of personal hygiene; after urinating and toileting the genitals, be sure to wash your hands with soap. Do not squeeze pus out of the urethra due to the risk of spreading infection. You should refrain from eating hot and spicy foods and alcohol. Cycling, swimming in the pool, and heavy physical activity are prohibited. Drinking plenty of fluids is recommended.

The main treatment for gonorrhea is the use of antibiotics (penicillin, cephalosporin, tetracycline, macrolides, etc.).

It must be taken into account that the cessation of discharge from the genital organs and the disappearance of subjective sensations 1 – 2 days after starting to take medications does not mean a complete cure, since gonococci can persist for a long time in individual encysted lesions. In order to monitor the results of treatment, 7 to 10 days after its completion, a so-called provocation is performed using various methods (urethral massage with bougie, intramuscular administration of gonococcal vaccine, intake of salty, spicy foods, beer, etc.) and then smears are taken for bacterioscopic examination. Provocation and clinical examination are repeated after 1 month. Persons who have had gonorrhea are under dispensary observation for 2 months. In cases where gonococci are not detected in cultures and smears, there are no inflammatory changes in the urethra, prostate gland, seminal vesicles and Cooper glands in men, pain, menstrual irregularities and obvious palpation changes in the internal genital organs in women - persons who have had gonorrhea , are recognized as healthy and removed from the register. With gonorrhea, there is no immunity that protects against re-infection.

The prognosis in cases of timely and correct treatment of acute gonorrhea is usually favorable. Violation of the timing of treatment, its insufficient effectiveness can lead to the transition of the disease to a chronic form and various complications. The consequences of chronic gonorrhea in men can be narrowing of the urethra, chronic prostatitis, sexual dysfunction, and in women – chronic adnexitis, infertility.

Prevention. The basis of the fight against gonorrhea is public prevention measures, which consist of identifying and sanitizing persons who are sources of the infectious agent, monitoring the completeness and quality of treatment, conducting sanitary educational work among the population, and mandatory examination of all family members of a person with gonorrhea.

The best preventive measure is a condom, which equally protects both men and women from contracting gonorrhea. For personal prevention purposes, men are advised to immediately urinate after accidental intercourse and wash their penis with soap. The most effective method of preventing gonorrhea is copious rinsing of the anterior urethra with a solution of potassium permanganate (1:6000), which mechanically removes gonococci from the surface of the mucous membrane and creates unfavorable conditions for their reproduction. Such washings can be repeated. Washing is effective within 1 – 2 hours after sexual intercourse.

Personal prevention for women is less reliable than for men. Before sexual intercourse, you can insert a gauze swab soaked in a solution of sublimate (1:3000) or protargol (1:100) into the vagina, lubricate the vestibule of the vagina and urethra with Vaseline. Immediately after intercourse, a woman is recommended to remove the tampon, urinate, wash her genitals with soap and syringe with a solution of potassium permanganate (1:5000).

To prevent gonorrhea, children should sleep separately from their parents and have separate care items (towel, chamber pot, etc.). Children entering the children's group should be examined by a pediatrician, and if gonorrhea is suspected, by a venereologist. Before entering work at a children's institution, service personnel also undergo an examination by a venereologist every 3 months thereafter.

Gonorrhea is a classic sexually transmitted disease that affects the columnar epithelium of the urogenital tract. The causative agent is gonococcus (Neisseria gonorrhoeae). This microorganism dies quite quickly in the external environment, but is very stable when it ends up inside the body.

The modern name of the disease was introduced by Galen, who mistakenly interpreted discharge from the urethra of men as seminal discharge (Greek, hone-seed-+-rhoia- discharge). People who do not know medical terminology call gonorrhea gonorrhea, so this disease has a second definition. The disease primarily affects the mucous membranes of the genitourinary organs. Damage to the conjunctiva, mucous membranes of the pharynx, and rectum is also possible.

Unfortunately, with gonorrhea, the symptoms may not be acute; in most cases, it occurs mildly, and therefore often becomes complicated. If you are not puzzled about how to treat gonorrhea at home, then it can cause inflammatory processes in the pelvic organs, leading to infertility in women and men.

The disease is common mainly among people 20-30 years old, but can occur at any age. The main symptoms of the disease are purulent discharge from the urethra, frequent urge and pain during urination.

How is gonorrhea transmitted?

Infection with Neisseria gonorrhoae occurs as a result of sexual contact with an infected person without a condom. By the way, transmission of the pathogen can occur not only in the case of vaginal intercourse, but also oral and anal intercourse.

Women get sick in almost all cases of contact with a patient with gonorrhea, but men do not always, which is associated with the narrowness of the urethral opening. The first signs of the disease appear 2-5 days after infection.

Gonococci primarily affect parts of the genitourinary system lined with columnar epithelium - the mucous membrane of the cervical canal, fallopian tubes, urethra, paraurethral and large vestibular glands. People do not have innate immunity to the gonorrhea pathogen, and also cannot acquire it even after suffering from the disease.

There is also a possibility of fetal infection during pregnancy. In this case, a woman can become infected both before conception and during pregnancy. To prevent serious consequences, you need to cure gonorrhea on time. For this purpose, special drugs are used that destroy the causative agent of the disease. We will talk about them below.

The first signs of gonorrhea

As for gonorrhea, the first signs can be noticed 2-5 days after sexual intercourse, this is how long the incubation period lasts.

Signs in men– itching, irritation in the area of the head of the penis, which becomes more painful during urination;
Signs in women– either a complete absence of complaints, or frequent urination, tingling, burning in the genital area.

When a newborn is infected during childbirth, the mucous membranes of the eyes and genitals of girls are affected.

Gonorrhea symptoms

Gonorrhea can be acute and subacute - up to 2 months have passed from the moment of infection to the onset of symptoms, and chronic - after more than 2 months. As you already know, the incubation period for gonorrhea rarely exceeds 7 days. After this period, the first signs of the disease appear, which are listed above.

Then gonorrhea itself appears, the symptoms of which are very characteristic - a frequent urge to urinate and purulent, thick yellowish-brown discharge from the urethra. The discharge has an unpleasant odor and becomes thicker after a while.

Common symptoms in women:

Purulent and serous-purulent vaginal discharge;
Frequent and painful urination, burning, itching;
Redness, swelling and ulceration of the mucous membranes;
Intermenstrual bleeding;

Unfortunately, in women the symptoms are not as obvious as in men; 50-70% of women with gonorrhea do not experience any discomfort, so they are often diagnosed with a chronic disease.

In men, gonorrhea begins with burning and itching of the penis, especially during urination. When pressing on the head, a small amount of pus is released. If the problem is not treated, the process spreads to the entire urethra, prostate, seminal vesicles, and testicles.

Main symptoms in men:

Itching, burning, swelling of the urethra;
Abundant purulent, serous-purulent discharge;
Frequent, painful, sometimes difficult urination.

It is worth considering that there is now a noticeable number of low-symptomatic and asymptomatic cases of the disease. In addition, the symptoms are not always typical, since a combined infection (with trichomonas, chlamydia) is often detected, all of which complicates the diagnosis and timely treatment of gonorrhea.

Diagnostics

The diagnosis of gonorrhea is based on data from bacteriological and bacterioscopic examination and identification of the pathogen. Modern methods such as DNA diagnostics, ELISA and RIF methods are used.

It is mandatory for representatives of both sexes to examine discharge from the genital organs. From material taken from each affected organ and urogenital tract, smears are prepared on two glasses. How long gonorrhea is treated will depend on timely diagnosis, so do not hesitate to take the necessary tests when the first symptoms occur.

Treatment of gonorrhea

You should not treat gonorrhea on your own, as this can lead to the disease becoming chronic and causing irreversible damage to the body.

Considering that in 30% of cases the disease is combined with chlamydial infection, treatment for gonorrhea should include:

A drug active against gonococci - cefixime, ciprofloxacin, ofloxacin.
A drug active against chlamydia is azithromycin, doxycycline.
In the fresh stage, a single use of antibiotics is sufficient.

In addition, a set of procedures is prescribed that contribute to the patient’s recovery. This includes local treatment, means to strengthen the immune system, restoration of microflora through and physiotherapy methods.

It is necessary to refrain from drinking alcohol, spicy and spicy foods. Avoid sexual contact. Intense physical activity, cycling and swimming in the pool are prohibited - compliance with all these measures will help cure gonorrhea faster. Treatment of all sexual partners is mandatory. It is strongly recommended to undergo monitoring after treatment for gonorrhea, even if you feel well.

Tablets for gonorrhea are prescribed at the initial stage of development of the disease and in the absence of its complications in the form, etc.

Consequences of gonorrhea

Among the consequences of an advanced form of the disease in men are impaired spermatogenesis, inflammation of the penis and inner layer of the foreskin, as well as damage to the testicle and its epididymis, orchitis, epididymitis, or, which can lead to infertility.

In women, inflammation passes from the vagina to the uterine cavity and fallopian tubes, the inflammatory process in which threatens to form an obstruction, causing infertility.

To avoid complications, it is worth taking timely prevention - this means avoiding casual sexual intercourse and using a condom in situations where you are not sure in advance about the health status of your partner. If you follow these simple rules, you won’t have to think about how and how much to treat gonorrhea.

Dictionary of medical terms

gonorrhea (gonorrhoea; Greek gonorrhoia discharge of semen; from gono- + rhoia discharge; syn. gonorrhea)

venereal disease caused by gonococci (Neisseria gonorrhoeae), characterized by predominant damage to the mucous membranes of the genitourinary organs.

Explanatory Dictionary of the Living Great Russian Language, Dal Vladimir

gonorrhea

and. Greek painful flow from the genital parts.

Explanatory dictionary of the Russian language. D.N. Ushakov

gonorrhea

gonorrhea, pl. no, w. (Greek gonorroia, lit. expiration of semen) (med.). Venereal disease - purulent inflammation of the urinary tract; same as gonorrhea.

Explanatory dictionary of the Russian language. S.I.Ozhegov, N.Yu.Shvedova.

gonorrhea

And, well. Venereal disease is a purulent inflammation of the genitourinary organs.

adj. gonorrheal, oh, oh.

New explanatory dictionary of the Russian language, T. F. Efremova.

gonorrhea

and. Venereal disease caused by gonococcus; gonorrhea.

Encyclopedic Dictionary, 1998

gonorrhea

GONORRHOEA (from the Greek gonos - seed and rheo - flow) (gonorrhoea) is a venereal disease caused by gonococcus. 3-5 days after infection, pain and suppuration appear from the urethra. Inflammatory complications are possible: external (balanoposthitis) and internal (prostatitis, epididymitis, oophoritis, endometritis) of the genitals, bladder (cystitis), joints (arthritis), etc. When gonococcus gets into the eye, blenorrhea develops. Gonorrhea is a common cause of infertility. Timely and correct treatment ensures full recovery.

Gonorrhea

(Greek gonórrhoia, from gónos ≈ seed and rhéo ≈ flow; according to the ancient Greeks, during G. there was an outflow of semen), gonorrhoea, fracture, an infectious disease belonging to the group of venereal diseases. The causative agent of G. is gonococcus. The source of infection is a person suffering from G. The infection is transmitted mainly through sexual contact; Children are usually infected extrasexually from mothers with G. during childbirth (gonococcus gets into the eyes, causing blenorrhea, or in girls into the genital opening). Infection can also occur from caregivers, through a shared bed, towel, pots, etc. contaminated with secretions. Immunity to G. does not exist, that is, each person can become infected with G. and, moreover, many times (reinfection). G. is not inherited. The duration of the incubation (latent) period ranges from one day to 2≈3 weeks (usually 3≈5 days).

Gonococcus, once on the mucous membrane of the genitourinary organs, quickly multiplies and causes an inflammatory process, accompanied by the formation of an inflammatory infiltrate and purulent discharge. With further development of the disease, the infiltrate becomes scarred, which may result in narrowing of the urethra. With scarring changes in the epididymis of men and the fallopian tubes of women, these tubular organs become impassable for sperm and eggs, which leads to infertility. Once in the blood, gonococci die, releasing gonotoxin, which can cause headaches, loss of appetite, as well as damage to the joints, tendon sheaths, nervous system, etc. Without treatment, with improper treatment or non-compliance with the regime, the process usually takes a chronic, protracted course ; under the influence of alcohol, spicy food, sexual arousal, sexual intercourse, etc., the process intensifies.

G. men. Gonococci initially affect the mucous membrane of the urethra, and inflammation increases gradually. Cloudy discharge appears from the urethra; 3≈5 days after infection, acute inflammation (urethritis) develops. The lips of the external opening of the canal turn red and swell; there is pain when urinating; profuse purulent discharge appears (anterior urethritis). When inflammation moves to the back of the urethra, the patient experiences frequent urges and severe pain at the end of urination, frequent and painful erections, emissions, sometimes mixed with blood in the sperm. The most common complication is inflammation of the prostate gland (prostatitis), seminal vesicles, and epididymis (unilateral or bilateral epididymitis), which can also cause male infertility.

G. women. Gonococcus primarily affects the mucous membrane of the cervix; the process proceeds sluggishly, without causing pain, and remains unrecognized for a long time. Not knowing about her disease, a woman does not seek medical help and, continuing sexual activity, becomes a source of infection. According to the course of the inflammatory process, they distinguish between G. of the lower section of the genitourinary system and G. of its upper section (the so-called ascending G.). G. of the lower section includes diseases of the urethra, paraurethral ducts, Bartholin's glands, cervix, and rectum. The external genitalia and vagina are rarely affected. When the urethra becomes inflamed, frequent, painful urination occurs. When the cervix is affected, profuse purulent discharge appears, which causes irritation, burning and itching in the external genital area. Erosion (epithelial defect) forms on the cervix. When pus leaks from the vagina, inflammation of the rectum (proctitis) can develop. With ascending hepatitis, the process spreads to the uterus, tubes, ovaries, and peritoneum of the small pelvis, which is facilitated by sexual activity, menstruation, abortion, and heavy physical labor. Ascending gastrointestinal tract begins with acute pain in the lower abdomen, fever, and bleeding. This form of G., even with modern methods of treatment, can lead to female infertility.

G. children. It occurs mainly in girls (usually from 3 to 8 years old) and extremely rarely in boys. In girls, the inflammatory process usually involves the vagina, urethra, and less often the rectum; the uterus and appendages are not affected. The disease begins acutely. The mucous membrane of the labia minora, the entrance to the vagina and the clitoris is swollen, reddened; profuse purulent discharge from the vagina. The skin of the labia majora becomes covered with dried purulent crusts. A painful, frequent urge to urinate appears, and the external opening of the urethra turns red. When the rectum is affected, the skin around the anus is swollen, bright red, and sometimes cracks appear between the folds of the skin.

Treatment: antibiotics, immunotherapy, physiotherapy, and local treatment. With proper treatment, recovery occurs regardless of the duration and severity of the disease, but the earlier it begins, the faster and more complete it is.

Prevention. Public prevention is based on the dispensary method of serving the population. Dermatology and venereology clinics and venereal disease clinics provide medical care to the sick person, monitor his treatment, identify and involve in examination the persons who were the source of infection, examine family members of the sick person, and conduct preventive examinations of certain groups of the population. Personal prevention ≈ exclusion of casual sexual intercourse, use of a condom, and also in the first hours after suspicious sexual intercourse, special treatment of the urethra in men and the vagina in women at emergency anti-venereal aid stations at vendetta dispensaries operating around the clock.

Lit.: Porudominsky I.M., Gonorrhea, in the book: Venereal diseases, M., 1956.

O. I. Nyunikova.

Wikipedia

Gonorrhea

ultrathin sections of gonococcus: A) the outer membrane of the cell wall is visible during the binary fission of the gonococcus; B) discharge from the patient’s urethra, gonococci on an epithelial cell.

With gonorrhea, the mucous membranes of the genital tract are most often affected, but the mucous membrane of the rectum, conjunctiva (in this case the disease is called blenorrhea), and oropharynx can be affected.

Examples of the use of the word gonorrhea in literature.

Typically, the test helps detect syphilis, venereal warts, genital herpes, gonorrhea rectum and pharynx, however, an asymptomatic infection is very difficult to diagnose.

Pneumonia, bronchitis, tonsillitis, sinusitis, inflammation of the middle ear, brucellosis, tularemia, cholecystitis, pancreatitis, peritonitis, furunculosis, osteomyelitis, inflammatory gynecological and urological diseases, gonorrhea.

Typhoid fever, paratyphoid fever, dysentery, brucellosis, tularemia, whooping cough, pneumonia, gonorrhea, trachoma, meningitis, in eye practice for the treatment of eye infectious diseases - conjunctivitis, blepharitis.

I had talent, by the way, I am Doctor Honoris Causa - not to be confused with gonorrhea, scum!

It is now known that for gonorrhea the typical discharge is yellow or yellow-green, thick in the early stages, which then becomes lighter and lighter, almost white, while remaining either thick or thinner, the composition of which then continues to change, and eventually it becomes completely white and take on a permanent character.

Babies quickly lose weight and become emaciated, or the child develops asthma or constant catarrhal inflammation of the nose and eyes, or ringworm appears on the face and head, or the child stops growing - you try to cure such children without success, and after some time you begin to understand that the child’s father was treated for a long time for gonorrhea and may be suffering from genital condylomas.

When a weakened patient suffering from diseases of bones and cartilaginous tissues suffers gonorrhea, severe swelling of the foreskin occurs, from which no remedies can help.

Asthma attacks after suppression gonorrhea, when complaints arise mainly after physical strain or overheating, as in most sycotic patients.

Bronchitis, pneumonia, lung abscess, cystitis, pyelitis, pyelonephritis, purulent meningitis, enteritis, purulent skin infections, infected wounds, gonorrhea, surgical infections.

Catarrhal inflammation also occurs in the bladder, kidneys and urethra, and chronic gonorrhea continues in the form of catarrhal or discharge typical of gonorrheal urethritis.

Similar severe inflammation with burning and tenesmus in the bladder and rectum in patients gonorrhea occurs quite rarely, it is in such cases that this medicine should be prescribed.

Suppression or improper treatment gonorrhea in the patient or his parents is the basis for the occurrence of lumbosacral radiculitis, arthritis, rheumatism, cartilage erosion and other bone and limb diseases: restlessness of the legs, dropsy of the extremities, cramps in the ankles and feet, swelling and painful stiffness of the ankles.

But three years ago, Raffi returned from the USA, where he had completely mastered the language, received a diploma in agriculture, an insatiable need for bottled beer and gonorrhea.

In just a few seconds of your acquaintance, he will test the potential bride for syphilis, gonorrhea, trichomoniasis, AIDS, which will allow you to get married as many times as you like in any environmentally friendly place.

A case of cure is described when there was a question of testicular cancer that occurred after epididymitis, which, in turn, was the result gonorrhea.