Slide Gonorrhea

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GONORRHEA GONORRHEA    Anci Onasis Beda Anci Onasis Beda   110 097110 097

039039

  Fatimah D.B.MalaFatimah D.B.Mala   110 206110 206020020

  Mail!nMail!n   110 206110 2060"00"0

 AD#$%OR & AD#$%OR &

d. Nasi!ani 'ainald. Nasi!ani 'ainal

%()ER#$%OR &%()ER#$%OR &

d. %i #ita!ani M*chta+ %,. -- d. %i #ita!ani M*chta+ %,. -- 

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$NROD(/$ON$NROD(/$ON

Gonorrhea : Bacterial InfectionGonorrhea : Bacterial Infection

caused bycaused by Neisseria gonorrhoeae Neisseria gonorrhoeae

The infection is almost alwaysThe infection is almost always

contracted during sexual activitycontracted during sexual activity

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E)$DEM$OOG E)$DEM$OOG 

%E & 4 5 1+" & 1

RA/E hle 8ld

 AGE  1" 19 !.:;0< cases=

GONORRHEA 

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E$OOG E$OOG 

 Neisseria gonorrhoeae Neisseria gonorrhoeae

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)AHOGENE%$%)AHOGENE%$%

To be based on morphology, N. gonorrhoeaeTo be based on morphology, N. gonorrhoeae

devided type, but only type !st " #nddevided type, but only type !st " #nd

were phatogenic for humanwere phatogenic for human

$ili play an important role$ili play an important role

The adherence of gonococci to the humanThe adherence of gonococci to the humanepithelial host cell an to polymorphonuclearepithelial host cell an to polymorphonuclear

neutrophiles is dependent on the pili andneutrophiles is dependent on the pili and

opa ligandsopa ligands

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/$N$/A FEA(RE%/$N$/A FEA(RE%

Incubation period varies from #%Incubation period varies from #%&& daysdays

$n men %!m,tmatic$n men %!m,tmatic $n 8men As!m,tmatic$n 8men As!m,tmatic

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/$N$/A FEA(RE%>/$N$/A FEA(RE%>

Gncccal $n?ectin in menGncccal $n?ectin in men

:inc*@atin ,eid 2" da!s= &:inc*@atin ,eid 2" da!s= &

'rethral discomfort'rethral discomfort

(ysuria(ysuria

$urulent discharge$urulent discharge

$olyuria and urgency$olyuria and urgency )ed or swollen opening of penis)ed or swollen opening of penis

*urethra+*urethra+

Tender or swollen testiclesTender or swollen testicles

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/$N$/A FEA(RE%>/$N$/A FEA(RE%>

 Ad*lt 8men :as!m,htmatic= Ad*lt 8men :as!m,htmatic=

% Increased vaginal dischargeIncreased vaginal discharge

% (ysuria(ysuria% Intermenstrual bleedingIntermenstrual bleeding

% enorrhagiaenorrhagia

% (ispareunia(ispareunia

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/$N$/A FEA(RE%>/$N$/A FEA(RE%>

O,htalmia Nenat*mO,htalmia Nenat*m

% $urulent con-untivitis$urulent con-untivitis

% ye pain, redness and purulentye pain, redness and purulentdischargedischarge

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D$FFEREN$AD$FFEREN$A

D$AGNO%$%D$AGNO%$% aleale

% 'rethritis Non Gonorrhea *'NG+'rethritis Non Gonorrhea *'NG+

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D$FFEREN$AD$FFEREN$A

D$AGNO%$%>D$AGNO%$%>

/emale/emale% Trichomonas vaginalis infection *Trichomoniasis+Trichomonas vaginalis infection *Trichomoniasis+

% 0andida albicans infection *0andidosis vaginalis+0andida albicans infection *0andidosis vaginalis+

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D$FFEREN$AD$FFEREN$A

D$AGNO%$%>D$AGNO%$%>% Gardnerella vaginalisGardnerella vaginalis infection *Bacterialinfection *Bacterial

 vaginosis+ vaginosis+

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D$AGNO%$%D$AGNO%$%

1istory ta2ing1istory ta2ing

$hysical examination$hysical examination

3upporting examination3upporting examination

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/OM)$/A$ON/OM)$/A$ON

aleale% pididymitis gonococcalpididymitis gonococcal%

In4amation and abscess formation inIn4amation and abscess formation inparafrenal " bulbourethral glandsparafrenal " bulbourethral glands

% $eriurethral abscess$eriurethral abscess% $rostatitis$rostatitis% 3eminal vesiculitis3eminal vesiculitis% 'rethral stricture'rethral stricture

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/OM)$/A$ON>/OM)$/A$ON>

/emale/emale

%  5cute salpingitis 5cute salpingitis

%

$elvic In4ammatory (isease *$I(+$elvic In4ammatory (isease *$I(+% Bartholinitis and Bartholin6s abscessBartholinitis and Bartholin6s abscess

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/OM)$/A$ON>/OM)$/A$ON>

(isseminated Gonococcal Infection(isseminated Gonococcal Infection

%  5rthritis%dermatosis syndrome 5rthritis%dermatosis syndrome

%

Gonococcal endocarditis "Gonococcal endocarditis "meningitismeningitis

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REAMENREAMEN

(epends on :(epends on :

%  5ntimicrobial resistance of the micro% 5ntimicrobial resistance of the micro%

organismorganism

% The anatomical site of gonococcalThe anatomical site of gonococcalinfectioninfection

% 0linical symptoms0linical symptoms

% 3ide e7ect of the drug3ide e7ect of the drug% 0ost0ost

% $ossibly coexisting chlamydial infection$ossibly coexisting chlamydial infection

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REAMEN>REAMEN>

'ncomplicated gonococcal infection of'ncomplicated gonococcal infection ofthe cervix, urethra and rectum :the cervix, urethra and rectum :

RecmmendedRecmmended

eimenseimens AltenatiCe eimens AltenatiCe eimens

/e?tiane 12"2"0 m/e?tiane 12"2"0 m

$M as sinle dse$M as sinle dse %,ectinm!sin 2 %,ectinm!sin 2

$M as sinle dse$M as sinle dse/eime 00 m al as/eime 00 m al as

sinle dsesinle dse

/i,acin "00 m/i,acin "00 mal as sinle dseal as sinle dse )enicillin eimens 2)enicillin eimens 2

3 ,eal ,l*s3 ,eal ,l*s

)@enedic)@enedic1 as sin le dse1 as sin le dse

Oacin 00 m alOacin 00 m al

as sinle dseas sinle dse

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REAMEN>REAMEN>

Gonorrhea with coexisting 0hlamydialGonorrhea with coexisting 0hlamydial

infection :infection :

 Aitm!cin 1 as sinle dse Aitm!cin 1 as sinle dse+  +  

D!c!cline 100 m ? 7 da!sD!c!cline 100 m ? 7 da!s

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REAMEN>REAMEN>

$regnancy8Breastfeeding :$regnancy8Breastfeeding :

0eftriaxone #&9 mg I, as single dose, or0eftriaxone #&9 mg I, as single dose, or

3pectinomycin # gr I, as single dose, or3pectinomycin # gr I, as single dose, or

 5moxisilin # % gr peroral plus 5moxisilin # % gr peroral plusprobenecid ! g peroral, as single doseprobenecid ! g peroral, as single dose** N.gonorrhoeae N.gonorrhoeae sensitive to penicillin+sensitive to penicillin+

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REAMEN>REAMEN>

(isseminated gonococcal infection(isseminated gonococcal infection

/e?tiane 1 $M $# eCe! 2 h*s+  /e?tiane 1 $M $# eCe! 2 h*s+  

/e?taime 1 $# eCe! ; h*s+  /e?taime 1 $# eCe! ; h*s+  

/i,acin "00 m $# eCe! 12 h*s/i,acin "00 m $# eCe! 12 h*s

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REAMEN>REAMEN>

;pthalmia neonatorum;pthalmia neonatorum

/e?tiane 2""0 mIJ $# $M+ as/e?tiane 2""0 mIJ $# $M+ as

sinle dsesinle dse

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)ROGNO%$%)ROGNO%$%

ost gonococcal infection respondost gonococcal infection respond

<uic2ly to antibiotic therapy<uic2ly to antibiotic therapy

$rognosis is excellent if therapy is$rognosis is excellent if therapy is

initiated promptly and completedinitiated promptly and completed

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HAN- O(