Gonorrhea
Infectious venereal disease, which is caused by gonococci. Among the specific inflammatory diseases of the female reproductive tract, gonorrhea infection ranks second.
Gonococci in women affect those parts of the genitourinary system that are lined with a cylindrical epithelium: the ureter's mucosa, the cervical canal, the ducts of the bartholin glands, the mucous membrane of the uterine cavity, the fallopian tubes, the ovaries, the peritoneum of the pelvis. During pregnancy, in childhood and in the period of menopause, gonorrhea can also occur.
The source of infection is a person with gonorrhea.
Ways of infection .
- the disease is transmitted mainly through sexual contact;
- through homosexual contacts, oral-genital contacts;
- very rarely by household means - through washcloths, towels, linens;
- during childbirth from a sick mother (eye and vaginal damage in girls).
In women, the clinical picture of gonorrhea is not uniform and depends on the localization of the process, the virulence of the pathogen, the age of the patient, the reactivity of her organism, the stage of the disease (acute, chronic).
Fresh gonorrhea in an acute form is manifested by a pronounced clinical picture: the temperature rises, severe pains appear in the lower abdomen, and vaginal discharge appears yellow-green. There is pain and burning when urinating, frequent desires on it. There is also swelling and hyperemia of the external genitalia.
Subacute form of gonorrhea is accompanied by a subfebrile condition, often marked clinical symptoms are observed. To it conditionally carry disease which has begun no more than 2 weeks ago. Torpid form is characterized by minor clinical manifestations or is asymptomatic, but a woman has gonococci in a bacterioscopic examination of the smear. With the latent form of gonorrhea bacteriological and bacterioscopic confirmation is not present, the symptoms are practically absent, but the patients are the source of infection.
Gonorrhea in pregnant women is often asymptomatic. May lead to complications of pregnancy, childbirth and the postpartum period, and also there is a risk factor for the fetus and the newborn. Possible complications in the mother (chorioamnionitis, subinvolution of the uterus, endometritis), in the fetus (prematurity, anophthalmia, intrauterine sepsis, death). Artificial termination of pregnancy is dangerous because of the possibility of infection of the uterus, ovaries, fallopian tubes.
Gonorrhea in children. The mechanism of infection: in newborns, infection occurs when the child passes through infected birth canal, or in utero through amniotic fluid, and from a sick mother while caring for the newborn. Older children may become infected with a shared toilet or towel, washcloth, bath. Gonorrhea in girls is acute with significant swelling and hyperemia of the mucous membranes of the genital organs, mucopurulent discharge, frequent and painful urination, burning, itching. The body temperature can rise, but it is possible and asymptomatic flow. Gonorrhea in girls gives the same complications that are observed in adult women. Infection of boys occurs very rarely because of the peculiarities of the structure of the genital organs.
Syphilis
Infectious venereal disease, which is transmitted sexually.
The causative agent of the disease is the microorganism pale treponema. The source of infection is a sick person.
Possible routes of infection :
- Sexual - the main;
- with homosexual contacts, oral-genital;
- household - often in children, with close personal contact (when a child sleeps with a sick parent, uses common hygiene items). The everyday way of infection in adults happens extremely rarely, for example, when kissing, when on the mucous membrane of the lips of the mouth there are syphilitic eruptions with a moist surface;
- professional - during the examination of patients for syphilis, which have rashes on the skin or mucous membrane with a moist surface;
- transplacental (through the placenta) - in cases where the pregnant woman is infected with syphilis, especially the secondary form. Then the child develops congenital syphilis;
- Transfusion (extremely rare) - due to transfusion of blood taken from a patient with syphilis.
Clinic. Since the penetration of the pathogen into the body and up to the first symptoms of the disease, an average of 3-4 weeks. This is the so-called incubation period. The causative agent has already got into the body, but the patient does not have any complaints and manifestations of the disease. Although in this period the person is already contagious. After the end of the incubation period, only the place where the pathogen penetrates appears first symptoms. This is the so-called hard chancre. Hard chancre is a superficial defect in the skin or mucous membrane (erosion), rarely - deep (an ulcer that, when healing, leaves a scar). A solid chancre of round or oval shape, dense in the base with clear, slightly raised edges and absence of inflammation around, painless, with a smooth surface and insignificant serous secretions. About a week later, when the chancre is localized on the genitals, inguinal lymph nodes on one side increase. There is rarely a bilateral increase in lymph nodes. This is the primary period of syphilis, which from the appearance of chancre lasts 6-8 weeks. Very often women do not notice the chancre on their genitals because of its painlessness and miss the primary stage of syphilis. After 6-8 weeks after the development of a solid chancre, the patient's body temperature may rise, night headaches, bone pains appear. This prodromal period at this time pale treponema intensely multiplies, penetrates into the blood and in patients on the skin and mucous membranes there is a scattered rash. This means that syphilis has passed into the secondary period. The first rashes are roseola - small (0.5-1 cm.) Red spots on the skin of the trunk, abdomen, limbs, which do not cause itching, do not protrude above the surface of the skin and do not flake. Then there are nodules (papules). At this time, erosive papules can appear on the skin and mucous membranes of the female genital organs. They are dense, neostroospavitelnye, with a diameter of a few millimeters to 1 cm, with a wet surface, on which there are many pathogens (pale treponem), so they are very contagious. They are painless. As a result of friction and irritation, these nodules increase and turn into hypertrophic papules or wide condylomas.
Treatment of venereal diseases of gonorrhea and syphilis is carried out in the conditions of a specialized hospital of the dermatovenerologic dispensary, respectively, with the instruction of the approved MOH of Russia. In some cases, the patient is treated by a venereologist in a polyclinic. When appointing a doctor, the doctor takes into account the clinical form, the severity of the process, the presence of complications. The treatment is aimed at eliminating the pathogen, focal manifestations of the inflammatory reaction, increasing the immunobiological reactivity of the organism. This is why self - medication is dangerous and fraught with serious complications.