Gonorrhea

A)Causative organism-

-Neisseria gonorrheae.

-Gram negaitive diplococcus.

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B)Incubation period-

-3-7 days.

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C)Site of infection-

1)Principal site of infection are columnar & transitional epithelium of genitourinary tract.

2)Squamous epithelium is resistant to gonorrhea.

3)Primary site of infections are-

a)Endocervix(Cervicitis).

b)Urethra(Urethritis).

c)Skene's gland.

d)Bartholin's gland(Bartholinitis).

4)Other sites of infections are-

a)Oropharynx.

b)Anorectal region.

c)Conjuctiva.

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D)Untreated gonorrhea infection leads to acute PID.

E)Upper genital organs are involved as gonococci attaches to spermatozoa.

F)Women with gonococcal infection are at risk of incubating syphilis.

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G)Clinical features-

1)Local-

a)Symptoms-

i)Dysuria(25%).

ii)Vaginal discharge(50%).

iii)Unilateral pain.

iv)Swelling over labia.

v)Rectal discomfort.

vi)Pharyngeal infection.

vii)Intermenstrual bleeding.

b)Signs-

i)Vaginal discharge.

ii)Congested opening of bartholin duct.

iii)Discharge from bartholin duct on pressure.

iv)Congested ectocervix.

v)Mucopurulent discharge.

2)Distant-

a)Perihepatitis.

b)Septicemia associated with fever, skin rash, arthralgia.

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H)Complication-

1)PID.

2)Infertility.

3)Ectopic pregnancy.

4)Dyspareunia.

5)Tubo ovarian mass.

6)Bartholin gland abscess.

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I)Diagnosis-

1)Nucleic acid amplification test(NAAT) of urine or discharge.

2)Gram test and culture test of discharge.

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J)Treatment-

1)Preventive-

a)Treat male sexual partner simultaneously.

b)Avoid multiple sex partner.

c)Use condom.

d)Adequate therapy of gonococcal infection.

2)Curative-(Single dose regimen)

a)Ceftriaxone- 250 mg IM.

b)Azithromicin- 1 gm.

c)Doxycyclin- 100mg.

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Gonorrhea full mind map

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