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12. Gonococcal infection. Clinic. Diagnostics. Treatment
Clinical manifestations. The incubation period is 3-7 days, rarely shortened to 2 days or extended to 2-3 weeks.
Clinical forms:
1) fresh gonorrhea - gonorrhea up to 2 months old from the onset of clinical symptoms:
a) acute;
b) subacute;
c) oligosymptomatic;
2) chronic gonorrhea - a disease lasting more than 2 months and of unknown duration.
Symptoms of gonococcal infections depend on:
1) localization of infection;
2) features of the pathogen;
3) reactivity of the macroorganism. Gonococcal carriage is the result of insensitivity of the urethral mucosa and genitourinary apparatus to a strain of gonococcus. At the same time, there is no reaction to gonovaccine, no pathological changes are detected during ureteroscopy.
Gonorrhea in prepubertal boys is manifested by purulent discharge from the urethra, dysuria and hematuria. Edema and balanitis of the penis, epididymitis and periurethral abscesses are rare. Gonococcal proctitis appears when an infection enters the rectum.
Conjunctivitis of gonococcal etiology is detected not only in the neonatal period and is characterized by an acute inflammatory process with abundant yellow or green purulent discharge. Gonococcal arthritis occurs in infants with perinatal infection, is observed in children of puberty, sometimes in the form of arthritis.
The disease in girls is multifocal, with damage to the vagina, vestibule, urethra, rectum, less often - Bartholin's glands. The chronic course of gonorrhea in girls is rare and is more often diagnosed during periods of exacerbation or during a preventive examination. Vaginal examination reveals focal hyperemia and swelling of the vaginal integument.
Diagnostics. The diagnosis of gonorrhea is made on the basis of history, clinical manifestations, the presence of intracellular gram-negative diplococci, and is confirmed by cultural studies.
Treatment is carried out in specialized hospitals. Antibiotics, sulfa drugs, good nutrition, drugs that increase the body's immune defenses, and local treatment are prescribed.
After the end of treatment, all sick children remain in the hospital for 1 month for 2-3 provocations and smear examinations for 3 days. With favorable research results, the child is admitted to children's groups.
Prevention. Gonococcal ophthalmitis in newborns is prevented by instillation of a 1% solution of silver nitrate into the conjunctival sac immediately after birth.
Author: Pavlova N.V.
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