GONORRHOEA
Gonnorrhoea is a veneral disease caused by gonococcus (Neisseria gonorrhoeae). The disease is acquired only through sexual intercourse with an infected person. In new born infants, gonorrheal infection of the eyes can occur if the mother is suffering from acute gonorrhea during child birth. The disease is widely prevalent in this country. It has been said that for each case of syphilis, there are 3 or 4 cases of gonorrhea.
PATHOLOGY:-
The causative organisms is gonococcus. It is a gram negative, bean shaped coccus which always remains in pairs, either intra cellular (inside the cytoplasm of a polymorph leucocyte) or extracellular (outside the cytoplasm). The organisms are present in abundance in urethral or vaginal discharge. Unfortunately, most of the women sufferers remain asymptomatic although they are infective. Prostitutes serve as the main source of infection, many of them being asymptomatic.
The incubation period varies from 3-10 days.
There is an acute inflammation of the urethra with formation of thick, purulent exudates. In females, there in acute vaginitis with purulent vaginal discharge. If the infection is not controlled, the neighbouring sexual organs – the epididymis, testes and the prostate in males and the fallopian tubes and the ovaries in females are likely to be involved. Thus, there may be epidymo-orchitis and prostitis in males and acute salpingitis and oophoritis in females. In females, pelvic peritonitis can occur. In severe infection, the organisms may enter the blood stream and cause septicaemia. Gonoccal septicaemia can cause acute arthritis, infective bacterial endocarditis, iritis, conjunctivitis and rarely, meningitis.
SYMPTOMS:-
- The patient complains of increases frequency of Micturation and dysuria (painful Micturation).
- Feeling of obstruction may be felt during Micturation or there may be acute retention of urine.
- These symptoms are followed by a thick, yellowish, purulent discharge from the urethra. In females, copious vaginal discharge is generally present along with other urinary symptoms.
- In males, acute epididymo- orchitis may develop causing severe pain, swelling and tenderness over the epididymis and the testis. During the acute stage, gonococcal prostatitis may cause retention of urine.
- In females, the bartholin’s glands may be affected resulting in painful abscesses. The infection may cause acute salpingitis.
- Severe pain in the lower abdomen and tenderness or lump may be felt in one or both the iliac fossae.
- Chronic urethritis is common. Chronic cervicitis and salpingo-oophoritis may occur.
- In males, chronic gonorrhoea usually produces stricture in the urethra. This results in a persistent feeling of obstruction during Micturation. Often, urine is passed in two streams.
- Sterility is likely to occur due to blockage in the seminal vesicles or involvement of the testes. In females, sterility may occur due to blockage in the fallopian tubes or affection of the ovaries.
- Feeling of obstruction may be felt during Micturation or there may be acute retention of urine.
- These symptoms are followed by a thick, yellowish, purulent discharge from the urethra. In females, copious vaginal discharge is generally present along with other urinary symptoms.
- In males, acute epididymo- orchitis may develop causing severe pain, swelling and tenderness over the epididymis and the testis. During the acute stage, gonococcal prostatitis may cause retention of urine.
- In females, the bartholin’s glands may be affected resulting in painful abscesses. The infection may cause acute salpingitis.
- Severe pain in the lower abdomen and tenderness or lump may be felt in one or both the iliac fossae.
- Chronic urethritis is common. Chronic cervicitis and salpingo-oophoritis may occur.
- In males, chronic gonorrhoea usually produces stricture in the urethra. This results in a persistent feeling of obstruction during Micturation. Often, urine is passed in two streams.
- Sterility is likely to occur due to blockage in the seminal vesicles or involvement of the testes. In females, sterility may occur due to blockage in the fallopian tubes or affection of the ovaries.
COMPLICATIONS:-
a. GONOCOCCAL ARTHRITIS:- it is a type of Pyogenic arthritis that usually involves one of the big joints. The commonest to be involved is one of the knee joints. The affected joint is swollen, red and hot and is usually associated with pyogenic effusion.
b. Rare complications include infective bacterial endocarditis, iritis and meningitis.
DIAGNOSIS:-
The diagnosis is based on
- History of recent exposure.
- Dysuria.
- Thick, purulent urethral discharge, and
- Demonstration of gonococci in urethral smear or cervical swab (in chronic male cases, urethral smears are obtained after prostatic massage).
- Culture of the urethral discharge may have be done. Complement fixation test may be needed in difficult cases.
- History of recent exposure.
- Dysuria.
- Thick, purulent urethral discharge, and
- Demonstration of gonococci in urethral smear or cervical swab (in chronic male cases, urethral smears are obtained after prostatic massage).
- Culture of the urethral discharge may have be done. Complement fixation test may be needed in difficult cases.
TREATMENT:-
- Pencillin is still the drug of choice in most cases.
- Acute gonorrhoea can be cured by a few injections of procaine penicillin in heavy doses.
- In chronic cases, benzyl penicillin should give for a longer period say 7 days.
- Some of antibiotics also will prescribe due to hypersensitive to pencillin in cases.
- Acute gonorrhoea can be cured by a few injections of procaine penicillin in heavy doses.
- In chronic cases, benzyl penicillin should give for a longer period say 7 days.
- Some of antibiotics also will prescribe due to hypersensitive to pencillin in cases.
HOMEOPATHIC TREATMENT:-
Some of homeopathic medicines for gonorrhoea is given below.
1. CALC SULPH.
2. CANTHARIS.
3. CANNABIS SATIVA.
4. COCHLEARIA.
5. DIGITALIS.
6. FERRUM PHOS.
7. KALI CHLORICUM.
8. MEDORRIHNUM.
9. MERC SOUL.
10. NATRUM SULPH.
11. NITRIC ACID.
12. PULSATILLA.
13. PETROSELINUM.
14. SEPIA.
15. TERAEBINTHINAE.
16. THUJA.
17. PHOSPHORUS.
18. SILICEA.
19. SULPHUR.
20. PHYTOLECCA.
21. TARENTULA.
2. CANTHARIS.
3. CANNABIS SATIVA.
4. COCHLEARIA.
5. DIGITALIS.
6. FERRUM PHOS.
7. KALI CHLORICUM.
8. MEDORRIHNUM.
9. MERC SOUL.
10. NATRUM SULPH.
11. NITRIC ACID.
12. PULSATILLA.
13. PETROSELINUM.
14. SEPIA.
15. TERAEBINTHINAE.
16. THUJA.
17. PHOSPHORUS.
18. SILICEA.
19. SULPHUR.
20. PHYTOLECCA.
21. TARENTULA.
22. PSORINUM.
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