Gonorrhea is a sexual infection, about a quarter of a billion cases are recorded each year. Despite modern methods of treatment, the disease is not amenable to complete control: the causative agent of gonorrhea mutates, gradually acquiring resistance to the newest antibiotics.
The disease belongs to the classics of venereology and has its own history. Ancient medical treatises (Galen) mention the "passive expiration of sperm" - gonorrhea, referring to the characteristic discharge from the penis. The Dutch and Germans preferred to rename gonorrhea to gonorrhea, linking the disease with travel and love pleasures.
Closer to the end of the 19th century, they were able to discover the causative agents of gonorrhea. They were diplococci - paired bacteria of round shape, resembling coffee beans. The first to describe all of their signs, ways of reproduction and effects on the human body was described by Neisser (1872) and gave the microorganisms their own name - gonococci. Grateful scientific community, in recognition of the merits of the scientist, officially renamed the gonococci in the Neisseria. Since then, the causative agent of gonorrhea has received a sonorous name - Neisseria gonorrhoeae.amoxicillin pregnancy
It is proved that the prevailing way of transmission of gonococcal infection is sexual contact. 50-70% of women get infected after the first contact, among men the incidence of infection is 25-50%.
It is recognized that gonorrhea is infected equally with both "everyday" sexual intercourse, and during oral or anal sex. The last two methods of infection are most frequent among homosexual and lesbian couples. There are no living gonococci on household items, swimming pools or bathing accessories: Neisseries do not reproduce outside the body and die, getting into the environment, within 2-4 hours.
The transfer of gonococci by contact and household is possible through bed and underwear, towels and toothbrushes, if they have fresh biomaterials of the infected person - saliva with an oral form of gonorrhea, discharge from the urethra, anus or vagina with the appropriate localization of gonorrhea. In a non-sex way, a child becomes infected in childbirth if the mother is sick or is a carrier of gonococci. In such cases, children in the period from 2 to 4 days of life develops blenorrhea of newborns, a specific inflammation of the conjunctiva.
The prevalence of gonorrhea does not depend on the degree of development of society or the economic well-being of countries. The EU statistics showed that the highest incidence rate is observed in traditionally rich countries and states with a "Nordic" character. A sad champion in the number of cases per 100 000 population was England (27.6), followed by Latvia (18.5), Iceland (14.7) and Lithuania (11.7) ranked third. It was also revealed that up to 60% of gonorrhea patients from the Netherlands and France were infected with homosexual contacts, in Norway - up to 40%.
For years, statistics have not changed with respect to the age of most patients with gonorrhea. Young people aged 15 to 34 remain at risk, accounting for up to 75% of all cases detected. It is noted that in countries that respectfully treat traditional marriage and family values, gonorrhea is much less common: in Greece, Romania, the Czech Republic and Spain, the incidence rate tends to zero.
Gonococci are very sensitive to habitat conditions. They die if the temperature is below 35 or more than 55 ° C, are susceptible to drying out and irradiation with sunlight, to even weak antiseptics. In fresh purulent masses, the living pathogens of gonorrhea only persist; They can comfortably multiply inside cells - in the cytoplasm of leukocytes, in the epithelial layer of the mucous membranes of the genital organs, rectum, mouth and eyes.
Often gonococci parasitize in Trichomonas, causing mixed infection, therefore, in the treatment of gonorrhea always use drugs that act simultaneously and on Trichomoniasis.
Gonococci do not know how to move around and are not able to form disputes. However, with the help of the finest filaments, they are fixed on the membrane of erythrocytes, spermatozoa and epithelial cells, due to which they move inside the body and are outside it. Around the Neisseria there is a semblance of capsules that protect against the effects of cellular enzymes. Therefore, "attackers" on gonococcus leukocytes can not digest them, and red blood cells and trichomonads become a barrier complicating the treatment of gonorrhea.
The phenomenon of resistance to antibiotics is explained by the formation of L-forms of gonococci that, when improperly treated for gonorrhea, lose some of the properties important for triggering an immune response. L-forms are difficult to treat: they do not give a vivid clinical picture of the disease, but are transmitted sexually and remain viable for a long time. Under favorable conditions (hypothermia, stress, colds, starvation), the infection becomes more active with signs of gonorrhea.
Duration distinguishes fresh form of gonorrhea, lasting no more than two months, and chronic, which lasts more than 2 months. Chronic gonorrhea is also diagnosed if the statute of limitations of the disease has not been established. Classification, based on the severity of symptoms, divides gonorrhea into acute, subacute and torpid - low-symptom and asymptomatic variants, or carriage of gonococci.
Gonococci mainly infect the lower parts of the genitourinary system, which are covered with a cylindrical epithelium. These are the mucous membranes of the paraurethral glands and the urethra in men; Urethra, cervical canal, fallopian tubes, bartholin glands - in women. The walls of the vagina cover a multilayered flat epithelium, normally it is immune to gonococci. The development of gonorrheic vaginitis occurs when the epithelium is loosened during pregnancy, at pubertal age, or at menopause.
After genial-oral contacts, gonorrheal tonsillitis, stomatitis (erosion and ulcers in the mouth) or pharyngitis (sore throat), after genital anal proctitis, infection of the eye mucosa - gonorrheal conjunctivitis. The disease spreads beyond the mucous membranes, destroys the tissues under the epithelium and provokes local inflammation. Without treatment, gonococci with lymph and blood are carried throughout the body, affecting the liver, joints, kidneys, and the brain. Possible development of sepsis.