gonococcal anorectitis
Introduction
Introduction to gonococcal anorectal inflammation Gonococcal anorectal inflammation is mainly seen in male homosexuals, accounting for 40%. Women are mostly caused by vaginal self-infection, accounting for 35% to 50%. Symptoms of rectal gonococcal infection may only have anal itching, painless mucus-like purulent secretions, or a small amount of bleeding, and may also be characterized by urgency and heavyness. However, anal canal mucosa congestion, purulent secretion, gonococcal culture positive, male homosexuality has no clinical symptoms, isolated gonococcal bacteria are mostly resistant strains, which may be due to some highly sensitive strains quickly being used in stools Salt or fatty acid kills, such gonococcal bacteria are resistant to bile salts and fatty acids, and often have multidrug-resistant genes in the chromosome, which is difficult to treat. basic knowledge The proportion of sickness: 0.2% Susceptible people: good for male homosexuals and women Mode of transmission: sexual transmission Complications: infertility, ectopic pregnancy, pelvic inflammatory disease, urethral stricture
Cause
The cause of gonococcal anorectal inflammation
Human being is the sole host of gonococcus. The gonococcal has no pathogenic ability to lower animals. It has repeatedly transplanted pus containing gonococcal bacteria in the human urethra into the eyes of rabbits, trying to cause gonococcal membrane inflammation, which has not been successful. It shows that humans lack the ability to kill gonococcal bacteria, so gonococcus can only invade humans and has no ability to invade lower animals.
Prevention
Gonococcal anal proctitis prevention
1. Promote the knowledge of sexually transmitted diseases, promote noble moral sentiments, and strictly prohibit prostitution.
2. The use of condoms can reduce the incidence of gonococcal infections.
3. Prophylactic use of antibiotics can reduce the risk of infection. You can take norfloxacin or amoxicillin before and after sexual intercourse, which can effectively prevent sexually transmitted infections.
4. Sex partners are treated at the same time.
5. Patients pay attention to personal hygiene and isolation, not to bed with family, children, especially girls, and bath.
6. Perform a system of neonatal silver nitrate solution or other antibiotic droplets to prevent gonococcal ophthalmia.
Complication
Complications of gonococcal anorectitis Complications, infertility, ectopic pregnancy, pelvic inflammatory disease, urethral stricture
The general prognosis is good. After a single treatment with a large dose of gonorrhea, the cure rate can reach 95%. If the treatment is improper or delayed, it can produce comorbidities or disseminated gonorrhea, leading to infertility, infertility, ectopic pregnancy, pelvic cavity. Inflammation, urethral stricture or blindness, etc., can be life-threatening in severe cases.
Symptom
The symptoms of gonococcal anorectal inflammation common symptoms, urgency, heavy purulent secretion, swelling, abdominal pain, diarrhea, fever
Mainly seen in male homosexuality, women are mostly caused by vaginal self-infection, the performance is urgency and heavy, there are pus and blood, anal canal mucosa congestion, purulent secretion, gonococcal culture positive.
Examine
Examination of gonococcal anorectitis
(1) Smear examination:
Take the patient's urethral secretions or cervical secretions for Gram stain, find Gram-negative diplococcus in polymorphonuclear leukocytes, smear for patients with simple gonococcal anterior urethritis with a large amount of purulent secretion, this method The positive rate is about 90%, which can be diagnosed initially.
The pharyngeal smear found that Gram-negative diplococcus could not diagnose gonorrhea, because other Neisseria species are normal in the pharynx, and the smear positive for atypical symptoms should be further examined.
(2) Training and inspection:
Neisseria gonorrhoeae culture is an important evidence for diagnosis. The culture method is a sensitive method for males with mild or asymptomatic symptoms. As long as the culture is positive, the diagnosis can be confirmed. Before the genetic diagnosis, the culture is recommended by the World Health Organization. The only way to screen for gonorrhea is to culture 80%-95% males and 80-90% females.
Diagnosis
Diagnosis and diagnosis of gonococcal anorectal inflammation
Differential diagnosis
(a) non-gonococcal urethritis
Although there is also a history of unclean sexual intercourse, but the incubation period is long (1 to 3 weeks), the symptoms are mild, the amount of urethral secretion is small, serous or mucopurulent, the trachomatis and Ureaplasma urealyticum are the main pathogens, and a few can be vaginal hair drops. Insects, Candida or herpes simplex virus, E. coli is seen in male homosexual urethritis patients, and gonococcal tests are negative.
(two) non-specific urethritis
Refers to bacterial urethritis unrelated to sexually transmitted diseases, such as urinary tract infection secondary to phimosis, or secondary infections caused by urethral catheterization and other urethral instrument operations. Microscopic examination is often Gram-positive cocci.
(3) Reiter syndrome
The main symptoms occurred in the order of urethritis, conjunctivitis and arthritis. The incidence was related to HLA-B. The cause was mostly Chlamydia trachomatis (sexually ill type), intestinal dysentery bacillus (intestinal type), occasionally after gonococcal urethritis It can be accompanied by skin and mucous membrane damage such as pussy keratosis (more common in palmar) and ring balanitis.
