GONORRHEA:
Gonorrhea remains still as an important health problem especially in developing countries because of poor level of knowledge on Sexually transmitted infections ( STIs). Gonorrhea is caused by organism known as Neisseria gonorrhoeae. When a person become infected , it takes about 3-7 days for this bacteria organism to multiply and increase in number.
Usually this organism, enter the body through the epithelium layers covering genitalia and urinary system. The primary site of infections are urethra, cervix and glands like bartholin and skene`s gland. The organism may only affect lower genitalia tract and produce infections of cervix (cervicitis) , infection of the urethra (urethritis) and glands. Oral cavity, pharynx, anus, rectum and conjunctiva are the other common sites in the body infected with this organism.
About 15% of untreated cervicitis, gonorrhea infection may spreads by ascend and produces infections of the pelvic known as pelvic inflammatory diseases (PID). Sometimes in few patients, the infections may infect the blood ( septicemia) and results into infections of several joints in the body. The gonorrhea infection can also spreads along the sperms to infect upper genitalia organs like uterus, Fallopian tubes and sometimes ovaries. Infection of uterus and Fallopian tube is common. Neisseria gonorrhoeae is usually manifest with others sexual transmitted infection especially Syphilis and chlamydial infections.
clinical features.
About half of people with gonorrhea, do not show any symptoms of the disease and are the one responsible in a higher percentage for transmission of this disease to uninfected people. The symptoms depend on the part of genital or urinary tract infected. The commonest symptoms are :
-painful or difficult urination
-foul smell vaginal discharge
-pain on one side of vagina and swelling of the labia due to infection of Bartholin gland.
-pain during or after sexual intercourse
signs:
-labia infected and look inflamed.
- mixture of mucus and pus vaginal discharge is the common sign
- cervix examination may reveal infection of the cervix.
Other organs like liver and joints may also affected by gonorrhea especially when the infection infect blood (septicemia) and spread to distant area of the body. In case of septicemia symptoms like fever, generalized joint pains, pain along the level of stomach (epigastric pain) due to infection of liver and skin rashes may occur.
complications:
The following are common complications of gonorrhea infection, if left untreated or poorly treated;
- it may result in a chronic pelvic pain
- infertility is the common complication
-difficult or painful sexual intercourse
-abscess of genitalia gland especially bartholin gland
- implantation of the pregnancy outside of uterine cavity( womb).
Diagnosis
Gonorrhea can be diagnosed clinically from above symptom and signs, but others sexual transmitted infection like Chlamydia can present almost the same as gonorrhea infection. Therefore, the definitive diagnosis of gonorrhea, can be done using Nucleic acid amplification test of the urine or genitalia discharge. Culture of urine or discharge from the genitalia can be done to isolated Neisseria gonorrhoeae organism and drugs sensivity can also be done.
Treatment
The common drugs recommend for the treatment of acute gonorrhea infection are the ceftriaxone 250mg IM plus azithromycin 1gm once orally and doxycline 100 mg orally every twelve hours for 7 days.
Prevention
-definitive therapy should be give and the patient should be followed by health provide until cured.
- both partners should be treated in the same time in order to avoid reinfection from untreated partner.
thanks.
by
DR MWANDA.
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