Gonorrhea

Epidemiology

the most touched groups are the women from 15 to 19 years and the men from 20 to 24 years.
the period of Incubation is usually from 2 to 7 days.
More than 50% of the men and the women can be Porteurs asymptomatic these Infection S, which are generally localized in certain parts of the body like the Rectum and the Pharynx.
Generally, the contacts are asymptomatic.
an asymptomatic chronic infection is possible.
the presence of a genital infection can facilitate the transmission of HIV.

Behavioral factors

Prone having sexual contacts with a person carrying a diagnosed infection or a compatible syndrome.
People having sexual relations not protected with a partner resulting from an area from strong endemicity and where the rate of resistance is likely to be higher.
Voyageurs who goes in countries where these infections is endemic and which has sexual relationships not protected with members from the local population (higher risk of resistance).
Hard-working of pornographic industry, prostitution.
Young credits sexually of less than 25 years which have several partners.

Diagnosis

Clinical signs

At the man

The first signs of alarm are, at the man:

mictionnelles Pains (important burns while urinating)
Flow of Pus at the end of the Rod
epididymal Pains
urethral Prurit

The demonstrations of an infection with Neisseria gonorrhoeae can appear in the form of:

After-effects at the man:

Orchi-épididymite
Syndrome of Reiter
Infertility (rare)

At the woman

The risks of complication are more important for the woman because the infection often develops without particular clinical signs and can thus evolve/move (see however photo Ci below). This infection, if it is not treated becomes complicated sometimes chronic Cystite and especially of urethral contracting.

vaginal Flow
Dysurie
abnormal vaginal Bleedings
low abdominal Pains
Dyspareunie deep

The demonstrations of an infection with Neisseria gonorrhoeae can appear in the form of:

Cervicite
high genital Infection
Urethritis
Périhépatite
Bartholinite

After-effect at the femme

Reached inflammatory pelvic person in charge of chronic pains
Infertility
ectopic Pregnancy
Syndrome of Reiter

In the two sexes

Pharyngitis
Conjunctivitis
Rectite, to see flows on the level of the rectum,
disseminated gonococcal Infection: Arthritis, Dermatite, Endocarditis, Meningitis

At the newborn

Conjunctivitis prevented by use of eye lotion with silver nitrate into systematic
Septicaemia

Bacteriological diagnosis

Evolution and consequences

Without treatment, the risks of evolution towards a irreversible sterility are very important, in the two sexes. Sometimes (less than 3 to 4% of the genital infections) the gonococci diffuse and can be located:

with the skin (aspect of sudden push of generalized acne),
in the articulation S (see arthritis of the knees)
or even (very exceptionally) in the Endocarde where they cause lesions mortals in the absence of effective cure.

Treatment

The treatment consists of the catch of Antibiotique S.

The evolution of resistance to antibiotics of the germ modified its catch of load according to the time: Sulphonamide at the end of the years 1930, one passed to the Pénicilline to increasing amounts, the latter being used as from the years 1980. The Fluoroquinolone S and the Céphalosporine S took over then, with the appearance of resistances as from the years 1990. This evolution presents real public health problems the more so as certain stocks can be resistant to several antibiotics at the same time. It should be noted that the proportion of these last varies in an important way according to the countries.

All the patients treated for a gonococcie should also be treated for a Chlamydiose, this infection being very frequently associated.

A treatment under direct observation of the catch of only one amount is desirable to guarantee the observance.

All the partners who had sexual relationships with the patient at least in the 60 days preceding the appearance of the symptoms, as well as the parents of infected new-born babies must undergo the same treatment as the case index. The people treated for a gonococcal infection should also be treated for a Chlamydiose.

Treatment of choice

Céfixime 400 Mg per bone in single amount

Alternative treatments

Due to Allergy to the treatment of choice, there are these possibilities:

Ceftriaxone 125 Mg in single amount in Intramuscular
Ciprofloxacine 500 Mg per bone in single amount
Ofloxacine 400 Mg per bone in single amount

International distribution

France

The gonococcie became rare in France for badly given reasons. The precautions related to the epidemic of AIDS are there certainly for something but the decline of the gonococcie had started before the AIDS is not known by the public. But the Sex tourism is a big factor of this disease in France.

Sources

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