Gonorrhea is an infection caused by the gonococcus and in the adult woman is contracted by sexual contact with an infected male.There is usually an interval of 2-5 days between exposure and the development of symptoms,but this interval varies from 1 ti 10 days.however an asymptomatic carrier state can persist for weeks or even months and throughout this time infection can be transmitted.
The bacteria attack first those tissues of the lower genital tract.
The gonococci are also spread by anal coitus.
The initial complaints of the patient are dysuria,frequency and purulent vaginal dscharge.This discharge causes soreness but not pruritus unless there is an associated Trichomonas infection.In severe cases the whole vulva become reddened and swollen.Cyctitis and proctitis can develop.
Generally the infection remains limited to the lower genital tract.Most wemen even in the acute and subacute stages of the primary infection ,notice nothing more than slight frequency,dysuria and discharge ,so slight that they pay little attention.It is this who are responsable for the spread of the infection and they can only be found and treated by an efficient system of "contact tracing".
No matter whether it has a dramatic or quiet onset,gonorrhea persist as a chronic but contagious disease for many years.The organisms linger in the endocervix,Bartholin's glands,periurethral tubules and rectum but gives rise to no symptoms or just a vaginal discharge.
the most important and sequel to gonorrhea is tubal damage and closue which threaten future reproduction.
In the classical case the diagnosis of gonorrhea is usually suggested by the history of esposure,the acuteness of the onset of a purulent discharge,the associated urethritis and the appearance of zones of congestion around the orifices of Bartholin's ducts.
The diagnosis can only be provide by the demonstartion of gonococci in the genital tract secretions or in the lower rectum.
The woman should not have passed urine before examination and not used the shower.Having wiped its orifice clean,the urethra is milked to obtain discharge from the paraurethral glands.
the best time to performe a test is immediatly after menstruation.
Treatment:
If there is a severe systeic reaction,or if acute salpingitis is present,the patient should be put completely at rest in hospital and given intensive antibiotic therapy in divided doses.
Penicillin(injection) is the remedy of choice in gonorrhea.If for any reason penicillin is contraindicated,the next choice is ampicillin taken orally.This can be given in a repeated dose of 2g for divided doses such as 500mg,four time daily for 2-4 days.Before penicillin or ampicillin it is advisable to adminiter with 1/2-1 hour previously probenicid 1g by mouth.
Gonorrhea is diagnosed by a medical test and treated after medical advise and supervision!
Be attent with the health of your sexual life,practice a good hygiene and use condom against transmited sexual diseases!
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