| ID | 216 |
|---|---|
| Name | GONORRHOEA |
| Cause | |
| Signs Symptoms | |
| Diagnosis | Diagnosis: 1. History- history of exposure may be present. 2. Clinical features- stated above. 3. Laboratory investigations- a. Gram staining- gram negative intracellular diplococci may be seen in stained secretion from infected tracts, b. Culture of exudate- growth of N. gonorrhoee on an appropriate media confirm the diagnosis. Complications: In case ofmale- 1. Urethritis 2. Stricture urethra 3. Epididymo-orchitis 4. Bacteremia, septicemia (rare & causes fever) In case offemale- 1. Cervicitis 2. Salpingitis 3. Oophoritis 4. Pelvic infection 5. Infertility In case ofinfant- Ophthalmia neonatorum- acute purulent conjunctivitis in infants bom to infected mothers may progress to impairment of vision or blindness. |
| Investigations | |
| Management | Management: A. Uncomplicated gonorrhoee: A suitable antibiotic of single adequate dose (listed below) is usually suf ficient- 1. Inj. Ceftriaxone 250mg i.m single dose. Or, 2. Cap. Cefixime 400mg single dose. Or, 3. Procaine penicillin 2.4gm i.m plus probenecid Igm orally. Or, 4. Ampicillin 2gm plus probenecid Igm by mouth. Or, 5. In patients allergic to penicillin- Co-trimoxazole 8 dispersible tablets (480mg/tablet) in a single dose. Or, Co-trimoxazole 5 dispersible tablets (480mg/tablet) 12 hourly for 3 doses. Or, 6. Tab. Azithromycin- a single dose of 2gm (2000mg). B. Complicated gonorrhoee: Relatively resistant- 1. Inj. Ceftriaxone 500mg i.m daily for 7 days. Or, 2. Cap. Cefixime 200mg twice daily for 14 days. Or, 3. Inj. Procaine penicillin 4.8gm i.m. plus probenecid Igm by mouth. Or, 4. Cap. Ampicillin 3.5gm plus probenecid Igm by mouth. Or, 5. Spectinomycin 2-4gm i.m. for penicillin allergic patients. Totally penicillin resistant isolates- 1. Inj. Cefotaxime 500mg to Igm i.m daily for 7 days. Or, 2. Ciprofloxacin 250mg orally (60% resistant). Or, 3. Spectinomycin 2-4gm i.m. for penicillin allergic patients. Multiple dose therapy for patients with complications need- 0 Ampicillin 2gm plus probenecid Igm followed by- 0 Ampicillin 500mg plus probenecid SOOmg 4 times daily for 14 days. C. For ophthalmia neonatorum- both systemic and local penicillin should be given |
| Introduction | Onorrhorea is the commonest venereal disease caused by the gram negative diplococcus ‘Neisseria gonorrhoea’ typically found inside the polymor-phonuclear cells, which infects columner epithelium in the lower genital tract. It is mostly transmitted during sexual activity. Besides, it may infect eyes, rectum and throat also. The incubation period is about 2 to 10 days. |
| History | |
| Etiology | |
| Clinical Features | Clinical features: In the male- the infection starts in the anterior urethra and tend to spread to the posterior urethra and epididymis. There is dysurea and a white or yellow purulent discharge from the urethra but symptoms may be mild or absent In females- in females the lower cervical canal is commonly infected but the urethra and rectum are also involved in 50% of patients. There may be vaginal discharge and dysurea but 50% of infected women have no symptoms. |
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