Gonorrhea

Июль 31, 2022

Содержание

2. Lection Gonorrhea Gonorrhoea is an old bacterial disease that is almost exclusively acquired through sexual intercourse.
3. Gonorrhea Neisseria gonorrhoea, a gram-negative intracellular diplococcus arranged in pairs with their apposing surfaces slightly flattened
4. Course of gonorrhea In virtually all cases transmission is the result of sexual contact. Incubation period
5. Pathogenesis Neither congenital, no acquired immunity to gonococcus develops in humans. The formed antibodies do not
6. Classification Present classification of gonorrhoea: 1) Fresh: a) acute, b) subacute, c) torpid 2) Chronic 3)
7. Clinical features of gonorrhoea Clinical features of gonorrhoea: a) fresh acute gonorrhoeal urethritis (anterior, total) Incubation
8. Varieties of gonorrhoea Gonorrhoea in small girls (for pediatricians). As a result of anatomical and physiological
9. Complications of gonorrhea Balanoposthitis, Phimosis, Paraphimosis, Thysonitis, Periurethral abscess, Littritis, Cowperitis, Prostatitis, Vesiculitis, Epididymitis, Urethral stricture,
10. Complications. Balanoposthitis. Balanoposthitis The swelling of the prepuce in phimosis looks as an enlarged penis, which
11. Complications. Phimosis. Balanoposthitis may lead to constriction of the prepuce so that the foreskin cannot be
12. Complications. Paraphimosis. An attempt to retract the prepuce in phimosis with force may lead to another
13. Complications. Cowperitis Cowperitis presents as fever, malaise and severe pain in the perineum with frequency, urgency,
14. Thysonitis, periurethral abscess, littritis Thysonitis is an inflammation of thysonic glands. Periuretral abscess - presents as
15. Complications. Epididimitis Epididymitis - inflammation of the epididymis, was formerly encountered in gonorrhoea much more frequently
16. Urethral stricture Urethral stricture could lead to obstructive symptoms and damages as well as recurrent urinary
17. Prostatitis Prostatitis is uncommon as attacks are cut short by the use of antibiotics. Symptoms include
18. Prostatitis Catarrhal prostatitis - when the inflammatory process is restricted to the excretory ducts there are
19. Treatment of gonorrhoea Gonorrhoea is managed by means of antigonococcal agents (antibiotics and sulphanilamides), methods for
20. Treatment of chronic gonorrhoea Specific and non-specific immunotherapy (provocation) are used for treatment of chronic, complicated
21. Criteria of recovery from gonorrhoea The disappearance of the external signs of the disease after treatment
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Lection
Gonorrhea
Gonorrhoea is an old bacterial disease that is almost exclusively

acquired through sexual intercourse. It is among the most common and widely recognised STDs throughout the world. Dr. K.H. Lau

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Gonorrhea
Neisseria gonorrhoea, a gram-negative intracellular diplococcus arranged in pairs with their

apposing surfaces slightly flattened to produce the characteristic reniform shape. It primarily affects columnar epithelium in genital mucosal surfaces of the urethra, accessory ducts and gland, as well as endocervix.

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Course of gonorrhea
In virtually all cases transmission is the result of

sexual contact.
Incubation period in men is usually 2 to 5 days. Extreme cases can vary from 1-14 days. Incubation period in women is difficult to estimate as many cases are symptomless.

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Pathogenesis
Neither congenital, no acquired immunity to gonococcus develops in humans. The

formed antibodies do not have defensive activity. Phagocytosis is complete, if gonococci were weakened by the use of drugs. The distribution of infection in the organism takes place through lymphatic and blood vessels. The pathogen cannot live in the blood as it has bacteriocidal properties.

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Classification
Present classification of gonorrhoea:
1) Fresh:
a) acute,
b) subacute,
c) torpid

2) Chronic
3) Latency

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Clinical features of gonorrhoea
Clinical features of gonorrhoea:
a) fresh acute gonorrhoeal urethritis

(anterior, total) Incubation period, clinical manifestation. What contributes to the development of posterior urethritis and most acute forms of the process. Period of acute gonorrhoea;
b) fresh subacute gonorrhoea. Period of the disease (from 2 weeks to 2 months). Decrease in the intensity of the process;
c) fresh torpid gonorrhoea is characterized by sluggish progress, with less subjective feelings. Period of the disease is till 2 months.
d) chronic gonorrhoea is characterized by sparse clinical features. Period of the disease is more than 2 months;

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Varieties of gonorrhoea
Gonorrhoea in small girls (for pediatricians). As a result

of anatomical and physiological peculiarities of the genitals of small girls the inflammation of vulva, vagina, urethra, rectum may occur. In elder girls gonorrhoea is same as in women. Acute vulvovaginitis progresses with intense clinical signs.
Gonorrhoeal pharyngitis (for dentists). In sexual perversion there may be a development of gonorrhoeal pharyngitis and tonsillitis. Clinically resembles catarrhal and banal inflammation, almost without any subjective feelings. Can lead to gonococcal sepsis.

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Complications of gonorrhea
Balanoposthitis,
Phimosis,
Paraphimosis,
Thysonitis,
Periurethral abscess,
Littritis,
Cowperitis,
Prostatitis,
Vesiculitis,
Epididymitis,
Urethral stricture,
Cystitis.

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Complications. Balanoposthitis.
Balanoposthitis The swelling of the prepuce in phimosis looks as

an enlarged penis, which is red and painful. The hard chancre localized in such cases in the corona glandis or on the inner surface of the prepuce cannot be examined for T. pallidum. The diagnosis of syphilis is made easier by the characteristic regional lymph nodes whose aspirate is examined for the causative agent.

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Complications. Phimosis.
Balanoposthitis may lead to constriction of the prepuce so that

the foreskin cannot be retracted. This condition is called phimosis. The swelling of the prepuce in phimosis looks as an enlarged penis, which is red and painful.

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Complications. Paraphimosis.
An attempt to retract the prepuce in phimosis with force

may lead to another complication called paraphimosis, in which the edematous and infiltrated preputial ring strangulates the glans. As a result of mechanical disorders of blood and lymph circulation, the swelling increases. Necrosis of the tissues of the glans penis and prepuce may occur if appropriate measures are not applied in time. In the initial stages of paraphimosis the physician removes the serous fluid from the swollen prepuce (by puncturing the thin skin with a sterile needle repeatedly) and attempts to 'reduce' the glans. If the manipulation proves ineffective, the prepuce must be cut.

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Complications. Cowperitis
Cowperitis presents as fever, malaise and severe pain in the

perineum with frequency, urgency, painful defecation, and sometime acute urinary retention. Rectal examination is agonizingly painful.

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Thysonitis, periurethral abscess, littritis
Thysonitis is an inflammation of thysonic glands.
Periuretral abscess

- presents as painful local swelling in the bulb or the fossa navicularis in the penis.
Littritis – is an inflammation of littrius glands,
Vesiculitis –is an inflammation of the seminal vesicle .

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Complications. Epididimitis
Epididymitis - inflammation of the epididymis, was formerly encountered in

gonorrhoea much more frequently than now. Gonococci evidently penetrate into the epididymis from the posterior urethra through the deferent duct, though it is quite possible that the infectious agent is brought here with the blood or lymph.

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Urethral stricture
Urethral stricture could lead to obstructive symptoms and damages as

well as recurrent urinary infection, leading to renal failure. Stricture may occur anywhere in the urethra but most commonly in the bulb. It is diagnosed by anterior urethroscopy or by urethrogram.

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Prostatitis
Prostatitis is uncommon as attacks are cut short by the use

of antibiotics. Symptoms include fever, perineal discomfort, pain on defecation and variable urinary complaints. Rectal examination may show a large, tense and fluctuant mass bulging into the rectum.

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Prostatitis
Catarrhal prostatitis - when the inflammatory process is restricted to the

excretory ducts there are no subjective disturbances and the disease takes an asymptomatic course.
Follicular prostatitis - Spread of the affection to the lobules of the gland and the development of pseudoabscesses in them
Parenchymatous prostatitis - involvement of the interstitial tissue into the process in an acute disease leads to more or less pronounced systemic disorders combined with symptoms of acute posterior urethritis

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Treatment of gonorrhoea
Gonorrhoea is managed by means of antigonococcal agents (antibiotics

and sulphanilamides), methods for stimulating specific and non-specific immunity, as well as by different methods of local therapy the character of which is determined by the localization and type of focal changes in the tissues and involved organs. In acute fresh uncomplicated gonorrhoea, antibiotic therapy only is applied. A complex of measures is needed in protracted, complicated and chronic forms.

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Treatment of chronic gonorrhoea
Specific and non-specific immunotherapy (provocation) are used for

treatment of chronic, complicated and torpid forms of gonorrhea.
Specific immunotherapy includes polyvalent gonococcal vaccine (gonovaccine).
Non-specific immunotherapy consists of:
lacto- and autohaemo- therapy
pyrogenal therapy
Chemical agents AgNO3
Alimentary provocation (using alcohol, sharp food, etc.)
Mechanical (introduction of metal bougies and tamponades)
Physiological (women’s month cycle)
Combined immunotherapy includes polyvalent gonococcal vaccine plus one of non-specific methods.

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Criteria of recovery from gonorrhoea
The disappearance of the external signs of

the disease after treatment does not serve as evidence that the causative agents have perished, because they may persist for a long time in some of the enclosed foci (latent gonorrhoea).
Full cure is determined in 7 to 10 days after completion of treatment. For this purpose combined provocation is carried out and then, 24, 48 and 72 hours later, smears are taken for bacteriological examination from the urethra and urine and the prostate secretion in males, and smears from the urethra, cervical canal and other involved organs in females. Whenever possible cultures are made simultaneously.

Gonorrhea

Содержание

Lection GonorrheaGonorrhoea is an old bacterial disease that is almost exclusively

GonorrheaNeisseria gonorrhoea, a gram-negative intracellular diplococcus arranged in pairs with their

Course of gonorrheaIn virtually all cases transmission is the result of

PathogenesisNeither congenital, no acquired immunity to gonococcus develops in humans. The

ClassificationPresent classification of gonorrhoea: 1) Fresh:a) acute, b) subacute, c) torpid

Clinical features of gonorrhoeaClinical features of gonorrhoea:a) fresh acute gonorrhoeal urethritis

Varieties of gonorrhoeaGonorrhoea in small girls (for pediatricians). As a result

Complications of gonorrheaBalanoposthitis,Phimosis, Paraphimosis, Thysonitis,Periurethral abscess, Littritis, Cowperitis,Prostatitis, Vesiculitis, Epididymitis,Urethral stricture,Cystitis.

Complications. Balanoposthitis.Balanoposthitis The swelling of the prepuce in phimosis looks as

Complications. Phimosis.Balanoposthitis may lead to constriction of the prepuce so that

Complications. Paraphimosis.An attempt to retract the prepuce in phimosis with force

Complications. CowperitisCowperitis presents as fever, malaise and severe pain in the

Thysonitis, periurethral abscess, littritisThysonitis is an inflammation of thysonic glands.Periuretral abscess

Complications. EpididimitisEpididymitis - inflammation of the epididymis, was formerly encountered in

Urethral strictureUrethral stricture could lead to obstructive symptoms and damages as

ProstatitisProstatitis is uncommon as attacks are cut short by the use

ProstatitisCatarrhal prostatitis - when the inflammatory process is restricted to the

Treatment of gonorrhoeaGonorrhoea is managed by means of antigonococcal agents (antibiotics

Treatment of chronic gonorrhoeaSpecific and non-specific immunotherapy (provocation) are used for

Criteria of recovery from gonorrhoeaThe disappearance of the external signs of

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