acute gonorrhea
Introduction
Introduction to acute gonorrhea Acute gonorrhea is an acute or chronic inflammatory sexually transmitted disease mainly caused by purulent infection of the mucosal surface of the genitourinary system caused by gonorrhea. Usually caused by unclean sexual intercourse, healthy people can also be infected indirectly through some kind of object or other means. basic knowledge The proportion of illness: 0.012% Susceptible people: mostly occur in young men and women Mode of transmission: sexually transmitted contact Complications: gonococcal urethritis prostatitis
Cause
Acute gonorrhea
1, traumatic infection
Trauma infection can easily lead to the appearance of gonorrhea. Gonorrhea virus of gonorrhea can invade the body through small ruptured wounds on the skin or mucous membrane. After a few days of incubation, the bacteria will multiply to a sufficient number and begin to develop. Therefore, treat broken wounds with caution to prevent the cause of gonorrhea.
2, unclean sex life
Unclean sex makes one of the causes of gonorrhea, and the cause of male gonorrhea is almost always caused by sexual contact. Gonorrhea patients are the source of infection, the speed of transmission is high, and the infection rate is very high. Usually, 3-5 days after infection, the onset of gonorrhea can be caused.
3, low immunity
The cause of gonorrhea is related to low autoimmunity. The cause of this gonorrhea mainly refers to non-sexual contagion. It is mainly caused by contact with gonorrhea patients' secretions or contaminated utensils, such as towels with secretions, foot cloth basins, clothes, and even the toilet seat of the toilet.
Prevention
Acute gonorrhea prevention
Gonorrhea is one of the most harmful sexually transmitted diseases, but the infection of gonorrhea has its own unique way, so you don't have to talk about it, it is alarmist. Some people live in hotels and are worried about infection. Bathing is also afraid of infection. This is not right. In fact, as long as the prevention and care of gonorrhea, please pay attention to the following points:
1. Promote knowledge of sexually transmitted diseases, promote noble moral sentiments, prohibit prostitution, promote self-satisfaction, and oppose sexual freedom and sexual liberation.
2. Use a condom to reduce the incidence of gonococcal infection.
3. Preventive use of Jiaoshen Jieyin lotion to clean or irrigate the genitals, disinfection and inhibition. Can reduce the risk of infection. It can be used to clean or lavage the genitals before and after sexual intercourse, which can effectively prevent infection of sexually transmitted diseases.
4. Simultaneous treatment of sexual partners.
5. Patients pay attention to personal hygiene and isolation, and do not have bed and bath with family, children and especially girls.
6. In public baths, do not enter the pool, promote showers.
7. Treat them promptly after illness to avoid transmission to spouses and others.
8. Be careful to isolate after illness, and avoid sex before you are cured.
9. Sprinkle the genitals and hands with soap regularly. Do not rub your eyes with pussy hands.
10. When a newborn is born, after invading the vagina of a gonorrhea mother, gonococcal invading the eyes may cause inflammation of the eyes. In order to prevent neonatal eye disease, every newborn baby should be treated with 1% silver nitrate for eye prevention.
Complication
Acute gonorrhea complications Complications gonococcal urethritis prostatitis
1. Gonorrhea glans dermatitis
It is caused by the purulent secretion of gonorrhea to stimulate the glans and the inner surface of the foreskin. Start local burning, itching, slight pain, foreskin edema, inner leaf erosion. The glans are flushed and mildly erosive. The foreskins of the severe cases all show significant edema, can not be turned up, the glans is swollen, and can be followed by inflammatory phimosis.
2, gonorrhea paraurethritis
Most of the secondary urethra is open around the outer urethra, or the ligament, or the medial line along the dorsal side of the penis. If the gonorrhea patient has such a paraurethral tract, it is easily affected and obvious inflammation occurs. Lymphocytic bacteria can be detected in purulent secretions, which is one of the sources of gonorrhea infection.
3, gonorrhea urethral stricture
Chronic gonorrhea after several months or years, easy to cause urethral stricture, the initial patient has no feeling, gradually urination is not smooth, the frequency of urinary urination, weak and weak urinary silk, can not be direct, until it can not be discharged or only drip out. Progressive urethral stricture, if not treated early, the consequences are extremely poor, sometimes life-threatening.
4, gonorrhea prostatitis is divided into acute and chronic two:
Acute prostatitis: one of the complications of gonorrhea after urethritis. Occurred in the third week of gonorrhea, frequent urination, dysuria, especially after urinating pain, dull pain near the perineum and anus, pain during stool. Anal examination of the prostate swelling, uneven surface, pressure of pain, urinary tract often have purulent secretions.
Chronic prostatitis: acute prostatitis is not completely treated, easy to change to chronic prostatitis. The performance of the perineum has a sense of falling, tenderness, frequent urination, and often low back pain. Anal examination of prostate hypertrophy, multiple induration, tenderness, mucus secretion during massage, check for white blood cells.
5, gonorrhea epididymitis
This disease is caused by invading the epididymis through the ejaculatory duct, which is the most common complication of acute posterior urethra gonorrhea. It manifests as swelling of the epididymis, hard surface nodules on the surface, and often radial pain. The body temperature in the acute phase rises to about 39 degrees Celsius.
6, gonorrhea seminal vesiculitis, gonococcal invasive duct, vas deferens or lymphatic invasion.
The perineal sensation of swelling, exacerbation of urination and defecation, painful sputum to the vas deferens and testicular radiation, urine clarification.
7, female gonorrhea complications: the main complication of female gonorrhea is gonococcal box inflammation, such as acute salpingitis, endometritis, secondary fallopian tube ovarian abscess and pelvic abscess caused by rupture, peritonitis. Sudden onset after menstruation, there are high fever, chills, headache, nausea, vomiting, lower abdominal pain, increased purulent leucorrhea. Both sides of the attachment are thickened and tender.
In female infants and pre-pregnant girls, there may be genital irritations, erythema, edema with purulent vaginal discharge and proctitis. Children can complain of dysuria or difficulty urinating, and parents can find that their underwear is contaminated.
Symptom
Acute gonorrhea symptoms Common symptoms Urethral pain urethra itch urethra has erythema and edema urethra secrete mucus or ... urination pain
Symptoms of male sexual acute gonorrhea: The main series of symptoms are dysuria and purulent discharge in the urethra.
1, the urethra mouth redness, itching and slight tingling, followed by thin mucus outflow, severe cases of mild swelling, causing dysuria.
2, a few days after infection, gonorrhea invade the entire anterior urethra, pus flows to the urethra and overflows. 3, urethral pain manifested as slight pain or severe pain, urinary pain in urination increased, especially when it began to urinate more painful. Due to pain during urination, he did not dare to urinate, but there was a cessation of urination.
Clinical features:
More than 198% are infected through unclean sexual contact;
2 more than 1 week after unclean contact;
3 a large amount of yellow-white viscous pus, urethral redness, dysuria, interruption of urination, and nighttime penis due to inflammatory stimulation of painful erection;
4 severe cases may have headache, joint pain, muscle pain, hypothermia, bacteremia or sepsis;
5 can be accompanied by bilateral inguinal lymph nodes, pain;
6 pus smear can be seen in the pus cells a large number of gonococcus.
The performance of female acute gonorrhea:
1, urethral inflammation due to urinary tract and paraurethral glands are susceptible to gonococcal invasion caused by inflammation, and even ascending infection, leading to bladder inflammation. The main symptom is dysuria, which means that the patient has burning pain when urinating. A large number of purulent secretions can be seen. If there is an abscess formation, there are painful masses on one or both sides of the urethral orifice, accompanied by painful urinary leaching or hematuria. In the acute phase, there is often an increase in body temperature.
2, vestibular gland inflammation: The patient often complained that the vaginal opening is swollen, painful or has a lump. On the side or both sides of the labia majora, a lump can be seen, tenderness, tenderness, and sometimes pus outflow. After the ulceration, the mass disappears, but it can be repeated. Whenever the mass enlarges, it is accompanied by high fever, pain and restlessness.
3, vulvitis: The patient complained of genital discomfort, swelling, itching, increased secretions were purulent, urinary burning or pain. It is often associated with inflammation of the internal genital tract, with elevated body temperature in severe cases.
4, proctitis: the patient complained of discomfort during bowel movements, or rectal bleeding. The discharged fecal mass is accompanied by purulent mucus, anorectal edema, and ulceration occurs in severe cases. More concurrent with gonorrhea genital inflammation.
5, vaginitis: patients often complain that vaginal secretions are pus-like, the amount of sputum, often accompanied by lower abdominal pain, lumbosacral pain, falling and other discomfort; patients with elevated body temperature, laboratory see gonorrhea can be diagnosed.
6, cervicitis: In the acute phase, there is often low back pain or lower abdominal pain, vaginal purulent secretions, examination can be seen that there is a large amount of purulent mucus overflow in the external cervix, cervical congestion, erosion, can be diagnosed when the gonorrhea is detected.
7, pelvic infections mainly manifested as acute endometritis and acute salpingitis. Due to the ascending infection of gonorrhea, pelvic inflammatory disease is later than vaginitis, cervicitis, and patients have high fever, chills, lower abdomen pain, refusal to press and other symptoms, even pelvic abscess formation, the lower abdomen has unclear mass. At the same time, the systemic response is obvious, such as acute abdominal pain, body temperature continues to rise, white blood cells and neutrophils increase.
8, other parts of inflammation: the same symptoms as male gonorrhea.
9, young girls acute gonorrhea: the main manifestations of acute vulvitis with urethritis, local redness, pain, increased secretions, dysuria, and even around the anus redness, ulceration, combined with proctitis.
Examine
Acute gonorrhea examination
Laboratory inspection:
Neisseria gonorrhoeae laboratory tests include smear, culture to check Neisseria gonorrhoeae, antigen detection, drug susceptibility test and PPNG determination, and genetic diagnosis.
(1) Smear examination:
Take the patient's urethral secretions or cervical secretions for Gram stain and find Gram-negative in polymorphonuclear leukocytes
Diplococcus, smear for patients with simple gonococcal anterior urethritis with a large number of purulent secretions, the positive rate of this method is about 90%, can be initially diagnosed, female colon secretions, more bacteria, poor sensitivity and specificity The positive rate is only 50-60%, and there is a false positive. Therefore, the World Health Organization recommends using a culture method to check female patients. Chronic gonorrhea has fewer positive gonococcal bacteria in the secretions, so the positive rate is low. Therefore, the prostate massage solution should be taken. Increase the detection rate.
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 use modified Thayer-Martin(TM) medium and New York City (NYC) medium. The domestic use of chocolate agar or blood agar medium contains antibiotics, optionally Inhibition of many other bacterial growth, cultured at 36 ° C, 70% humidity, containing 5% - 10% CO2 (candle) environment, 24-48 hours observation, colony morphology, Gram stain, oxidation Identification by enzyme test and sugar fermentation test, the positive rate of culture is 80%-95% for males and 80-90% for females.
Diagnosis
Diagnosis and identification of acute gonorrhea
diagnosis:
Acute gonorrhea is mainly based on medical history, especially the history of unclean sexual intercourse and laboratory tests of frequent urination, urgency, dysuria and purulent discharge. Identification with non-gonococcal urethritis, non-specific urethritis, Reiter syndrome, urinary tract infection, etc. is often required.
1) 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, and it is serous or mucopurulent. Chlamydia trachomatis and Ureaplasma urealyticum are the main pathogens, a few can be caused by Trichomonas vaginalis, Candida or herpes simplex virus, and Escherichia coli is found in male homosexual urethritis patients. According to the introduction of gonorrhea doctors in Wuhan Modern Urology Hospital, the gonococcal test was negative.
Non-gonococcal urethritis is often caused by infections such as chlamydia, mycoplasma, and trichomoniasis. It is also one of sexually transmitted diseases. It also has frequent urination, urgency, dysuria, and urethral discharge. Symptoms are similar to gonorrhea. The main difference between them is that the gonorrhea patients have yellow thick secretions in the urethra, while the non-gonococcal urethritis patients have only clear secretions in the urethra. Gonorrhea gonococcal test was positive, but non-gonococcal urethritis gonococcal test was negative. In addition, the direct smear of non-gonococcal urethritis has a polymorphonuclear leukocyte count of >5 in a 1000-fold microscope field, which is also diagnostic.
2) Non-specific urethritis
Refers to bacterial urethritis unrelated to sexually transmitted diseases, such as urinary tract infection secondary to phimosis, or following new marketing rules to promote corporate growth, e-commerce marketing, food and beverage marketing, construction, real estate, marketing, consumer goods marketing, urethral catheterization and other urethra Infection after injury caused by instrument operation. Microscopic examination is often Gram-positive cocci.
3) Reiter syndrome
The main symptoms occur in the order of urethritis, conjunctivitis, and arthritis. The incidence is related to HLA-B, and the cause is mostly Chlamydia trachomatis (sexually transmitted disease type) and intestinal dysentery bacillus (intestinal type). Occasionally, after the onset of gonococcal urethritis, it can be accompanied by skin mucosal damage such as pussy keratosis (more common in palmar) and ring balanitis.
4) Urinary tract infection
Generally, E. coli causes acute urinary tract infections, which are common in children and women. Frequent urination, urgency, and dysuria may occur, but there is no purulent discharge. The patient had no history of unclean sexual intercourse. For routine urine examination, red and white blood cells were observed, and gonococcal examination was negative. Gonorrhea has a typical history of unclean sexual intercourse, in addition to urinary frequency, urgency, dysuria and other bladder irritation symptoms, especially the symptoms of urethral discharge pus, pus yellow thick, pus for gonococcal culture is positive.
