Gonorrhea
Gonorrhea - STD caused by the gonococcus. Transmitted primarily by Popov. Vnepopovoy route of infection are rare (in children when using shared with her sick mother with a towel and linen). Pathogen infection affects mainly the divisions of the genitourinary system, lined with single-layered epithelium: the mucous membrane of the urethra, the excretory ducts Bartholin’s gland, the cervical canal, uterine body, fallopian tube. Often, the process involved paraurethral passages, ovarian surface epithelium, rectal mucosa, pelvic peritoneum. Inflammation of the mucous membrane of the vagina (gonorrheal coleitis) is possible with special conditions of the female organism: in childhood, during pregnancy and menopause. The inflammatory exudate contains large amounts of fibrinogen, quickly drop down into fibrin, thereby contributing to delimitation of the inflammatory process with the formation of numerous adhesions. The spread of infection takes place mainly on pre-existing canals. The incubation period of 3-4 days. Immunity to gonococcal hardly generated.
Distinguished the following forms of disease: fresh gonorrhea (acute, subacute, torpid), chronic and latent. Torpid (asymptomatic) form is characterized by minor clinical manifestations in patients with detected parasite. For latent gonorrhea typically is a condition where gonococci in smears and crops do not appear, symptoms are practically absent, and the woman is nevertheless a clear source of infection.
Gonorrheal urethritis. At the acute stage, patients complain of pain and stinging when passing urine, in the chronic stage there are no complaints. On gynecological examination – redness and swelling in the area of the external orifice of the urethra and mucous-purulent discharge from the urethra. In the inflammatory process often affects the paraurethral passages.
In chronic urethritis observed only thickening of the walls of the urethra (by palpation through the anterior wall of the vagina).
Gonorrheal endocervicitis along with urethritis – the most common site of disease. In the acute stage – puromucous whites and low abdominal pain. On examination of the cervix with vaginal mirrors reveal redness and loosening mucous membrane in the throat oblasti’naruzhnogo uterine, cervical mucous-purulent leucorrhoea, hanging in the form of tape. In the chronic stage of selection are mucous membranes, patients do not report the complaints. Around the outer pharynx cancer is often eroded.
Gonorrheal bartholinitis. Inflammation always begins with a ductless gland (kanalikulit), it expressed hyperemia in the external opening of the excretory ducts (gonococcal spots). When you join a secondary infection occurs psevdoabstsess gland with characteristic clinical picture (see Bartolini).
Gonorrheal proctitis occurs relatively rarely, when infected secretions flowing from the priest’s authority. The acute stage is characterized by burning sensation in the rectum and tenesmus, in the chronic stage, these symptoms are not pronounced.
Gonorrheal endometritis. ascent of infection (for the area of internal uterine mouth) promote menstruation, abortion, birth, intrauterine intervention (diagnostic curettage, hysterosalpingography, and others). In the inflammatory process in gonorrheal endometritis involved as basal and the functional layers of endometrium. During the next menstruation rejection mucosa is delayed, which is manifested typical giperpolimenoreey (menorrhagia). Acute phase: abdominal pain, subfebripnaya temperature, sero-purulent discharge. When studying the vaginal uterus bit painful at palpation. For chronic-gonococcal endometritis is typical only a symptom of menorrhagia.
Gonorrheal salpingoophoritis usually bilateral, whereas in salpingoophoritis, caused by other microbes, the inflammatory process is more often one-sided. In the acute stage of the patients concerned about abdominal pain, fever, dizuricheskie disorders, menstrual irregularities (see dysfunctional uterine bleeding). At vaginal examination showed an increase, swollen appendages of the uterus, sharply painful on palpation. Often joining the phenomenon pelvic peritonitis. In the chronic stage, patients complain of recurrent abdominal pain, often – its recurrence influenced by nonspecific factors (hypothermia, influenza, etc.). Typically the pipe infertility (primary or secondary).
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