Gonorrhoea Know About It
Gonorrhea is a sexually transmitted infection (STI) of epithelium and commonly manifests as cervicitis, urethritis, proctitis, and conjunctivitis.
Microbiology
Neisseria gonorrhoeae is a gram-negative, nonmotile, non-spore-forming organism .
Epidemiology
Gonorrhea remains a major public health problem worldwide, is a significant cause of morbidity in developing countries, and may play a role in enhancing transmission of HIV.Gonorrhea predominantly affects young, nonwhite, unmarried, less educated members of urban populations.
Clinical Manifestations
Gonococcal Infections in Males
Acute urethritis is the most common clinical manifestation of gonorrhea in males.
The usual incubation period after exposure is 2–7 days, although the interval can be longer and some men remain asymptomatic.
Urethral discharge and dysuria, usually without urinary frequency or urgency, are the major symptoms.
The discharge initially is scant and mucoid but becomes profuse and purulent within a day or two.
The clinical manifestations of gonococcal urethritis are usually more severe and overt than those of non gonococcal urethritis, including urethritis caused by Chlamydia trachomatis.
Most symptomatic men with gonorrhea seek treatment and cease to be infectious. The remaining men, who are largely asymptomatic, accumulate in number over time and constitute about two-thirds of all infected men at any point in time.
Other unusual local complications of gonococcal urethritis include edema of the penis due to dorsal lymphangitis or thrombophlebitis, submucous inflammatory "soft" infiltration of the urethral wall, periurethral abscess or fistulae, inflammation or abscess of Cowper's gland, and seminal vesiculitis. Balanitis may develop in uncircumcised men.
Gonococcal Infections in Females
Gonococcal Cervicitis
The minor symptoms may include scant vaginal discharge issuing from the inflamed cervix without vaginitis or vaginosis and dysuria often without urgency or frequency that may be associated with gonococcal urethritis.
Gonococcal Vaginitis
Gonococcal vaginitis can occur in anestrogenic women .The vaginal mucosa is red and edematous, and an abundant purulent discharge is present. Infection in the urethra and in Skene's and Bartholin's glands often accompanies gonococcal vaginitis. Inflamed cervical erosion or abscesses in nabothian cysts may also occur. Coexisting cervicitis may result in pus in the cervical os.
Pharyngeal Gonorrhea
Pharyngeal gonorrhea is usually mild or asymptomatic, although symptomatic pharyngitis does occasionally occur with cervical lymphadenitis. The mode of acquisition is oral-genital sexual exposure.
Ocular Gonorrhea in Adults
Ocular gonorrhea in an adult usually results from autoinoculation from an infected genital site. As in genital infection, the manifestations range from severe to occasionally mild or asymptomatic disease. Infection may result in a markedly swollen eyelid, severe hyperemia and chemosis, and a profuse purulent discharge.
Gonorrhea in Pregnant Women, Neonates, and Children
Gonorrhea in pregnancy can have serious consequences for both the mother and the infant. Recognition of gonorrhea early in pregnancy also identifies a population at risk for other STIs, particularly chlamydial infection and syphilis.
The risks of salpingitis and PID conditions associated with a high rate of fetal loss are highest during the first trimester.
Pharyngeal infection, most often asymptomatic, may be more common during pregnancy because of altered sexual practices.
Prolonged rupture of the membranes, premature delivery, chorioamnionitis, funisitis- infection of the umbilical cord stump, and sepsis in the infant are common complications of maternal gonococcal infection at term.
The most common form of gonorrhea in neonates is ophthalmia neonatorum, which results from exposure to infected cervical secretions during parturition.
Any STI in children beyond the neonatal period raises the possibility of sexual abuse. Gonococcal vulvovaginitis is the most common manifestation of gonococcal infection in children beyond infancy.
Anorectal and pharyngeal infections are common in these children and are frequently asymptomatic.
Investigations:
1. Blood culture
2. Gram staining
3. Complete urine analysis
Homoeopathic approach:
Cannabis sativa:
This is the favorite remedy of the homoeopathic school, though there is much difference of opinion as to its real value.
It comes in after Aconite when the disease has localized itself as is shown in the patient discharge, the great burning and tenderness on urinating.
The glans penis is dark red and swollen chordee is most likely present and what is still more painful, a spasmodic contraction of the sphincter vesicae on urinating.
Pulsatilla:
Ripe gonorrhoeas without much pain, but with a thick muco-purulent discharge which is yellow or yellowish green, call for Pulsatilla.
There is some pain in the loins going from side to side.
It is valuable remedy when the discharge becomes suppressed and orchitis results; here it will often establish the flow and reduce the swelling of the testicle.
Mercurius:
This remedy is for the first stage of an uncomplicated gonorrhoea there is no better simile, no better or more efficient remedy than Mercurius solubilis.
It is a most useful remedy for inflammatory symptoms such as chordee, and especially paraphymosis, phymosis and inflamed prepuce.
The discharge is greenish.
Cantharis:
Intense sexual excitement marks this remedy; an intense irritation with persistent erections which prevent urination; the pains are burning and excoriating , the discharge is purulent and especially bloody.
Copaiva:
Burning in the neck of the bladder and urethra, great dysuria, constant desire to urinate, and the urine smells of violets.
Haematuria.
Discharge yellowish, purulent, corrosive and milky.
If the trouble be accompanied by nettle rash the remedy is well indicated.
"Gonorrhoea Know About It", was submitted 02/17/2012 under category Education.