Gonococcus in the smear

Normally, the smear secret from the genital tract pathogen of gonorrhea (Neisseria gonorrhoeae) should not be. This infectious agent causes serious diseases of the genito-urinary tract, which are fraught with chronization and impaired ability to procreate, as well as the development of gonococcal sepsis. Gonococci in the smear are not uncommon. This is the second most common venereal infection after chlamydia. Especially dangerous is the asymptomatic course of gonorrhea in the young part of the female population of fertile age. In this category of patients, the infection is quickly complicated by pelvic inflammatory diseases, which in the absence of treatment can lead to persistent infertility.

Therefore, if gonococci were found in the smear, it means that urgent measures must be taken to neutralize the infection and secure its urogenital system. Simply put, you need to be treated. You can retake a smear if there are no obvious signs of malaise, however, ignoring such unpleasant news is more expensive. Having received a negative result in the retake, you also do not need to relax. The result can be affected by treatment with antibacterial drugs on a completely different occasion, washing with an antiseptic and visiting the toilet before the procedure. Competent medical advice in any case is required.

[1], [2], [3], [4], [5], [6]

How can I get infected?

The most likely route of transmission is unprotected sex in any form: genital, anal, oral, petting (just touch the mucosa with secretions from infected genitalia, get infected with fresh infected secretions that touch the genitals). The vertical path of transmission - from a sick mother to her child in the process of delivery also carries a high risk of infection.

The domestic way is rarely infected with gonorrhea, because the pathogen is very unstable and quickly dies in the external environment. But it is impossible to completely exclude this way of transmission, however, it is necessary to completely neglect the generally accepted sanitary norms, for example, to use one bath towel or washcloth, and without waiting until this object has dried. More risk to get the causative agent thus the female. Women in general get infected with unprotected sexual contact with the infected partner in 85% of cases, while in men this probability is 30-40%. This is facilitated by anatomical differences in the structure of the genital organs.

Gonococci and Trichomonas in the smear, as well as other pathogenic microbes - combined infection is often, even more often than monoinfection. However, some researchers believe that the risk of infection with Trichomonases is their mobility and the ability to transport other pathogens, in particular gonococci, to their more deeply located organs. The symptomatology in these cases can be blurred, but laboratory diagnosis is a classical smear of vaginal (urethral) discharge, bacterial culture on the microflora, and more modern methods - polymerase chain reaction, the detection of antibodies will help to arrange the points in diagnosis.

As practice shows, the inflammation in the vast majority of cases develops in the place of the primary introduction of the infectious agent. Infection with genital contact in women is localized, mainly in the urethra and para -urethral passages, Bartholin glands, at the entrance to the vagina, cervix, anus. The introduction of the gonococcus directly into the wall of the vagina (colpitis) is more common in pregnant women, because during this period the multilayered flat epithelium, which is practically inaccessible to infecting these infectious agents, undergoes structural transformations due to hormonal rearrangement - becomes loose, saturated with blood vessels, which contributes its penetration. With ascending gonorrhea, fallopian tubes, uterus, and ovaries are infected. In the stronger sex, it's easier - the primary inflammation is localized in the urethra.

Out-of-sex forms of gonococcal infection are localized on the mucous membrane of the mouth, eye conjunctiva.

Very rare, however, possible localization - in other organs due to migration of the pathogen through the blood or lymphatic vessels (metastatic form).

How does the disease manifest itself?

Gonococci in a smear in women may well become an unpleasant surprise as a result of a preventive examination by a gynecologist. In women, biomaterial for research is taken from the mucous membrane of the vagina, cervical canal and urethra. If necessary, they can examine the microflora of the rectum, the posterior pharyngeal wall, tonsils and the oral cavity.

In most patients (about 70%) gonorrhea is asymptomatic or with unexpressed symptoms. On average, symptoms appear within the first three to five days after infection, although sometimes the latent period can last for two weeks. Basically - this is a variety of violations of the process of emptying the bladder (dysuria) and yellowish-white vaginal discharge.

The condition can be complicated by pulling pains in the lower abdomen above the pubis or from the side. In cases of ascending infection in the uterus, epididymis and pelvic area of the peritoneum, mucopurulent discharge can have bloody veins, the menstrual cycle is disrupted. The uterus becomes painful, palpation reveals its increase and softening. Attachments can become clogged with pus, these clusters can be mistaken for a neoplasm during palpation. The peritoneum becomes inflamed, which threatens the development of peritonitis.

The appearance of such symptoms does not directly indicate the presence of gonococcal infection, however, it should be the reason for the examination.

Approximately the third part of infected women is acutely ill with abundant purulent secretions, pruritus and edema of the vulva, pain in the lower abdomen, frequent urination, accompanied by severe discomfort, sometimes accompanied by a high temperature (38.5 to 40 ℃). If the woman decided to "heal" herself and drank the course of antibiotics, temporary relief may come, acute symptoms will go away, however, the probability is high that the infection will continue, go into chronic form and someday manifest unexpected and severe complications.

The presence of randomly revealed gonococci in a smear in a woman indicates that she was infected and is the carrier of gonorrhea. Absence of symptoms does not speak about well-being, pathological changes occur in the microflora of the vagina and cervical canal, which eventually affect various organs of the genitourinary system. Chronic infection leads to irreversible consequences - tubal obstruction, leading to persistent impairment of fertility, development of ectopic pregnancy, any other organs and systems can be affected. A rare but serious complication is that gonorrheal sepsis can result in a fatal outcome.

Gonorrhea in the stronger sex is usually manifested by severe symptoms of gonorrheal urethritis. Purulent discharges from the urethra, which are becoming more abundant, hyperemic and edematous outlet of the urethra, discomfort in the process of urine-resorption, later, when the process spreads to the posterior urethra, frequent urges, a feeling of incomplete emptying of the bladder and other unpleasant symptoms usually join force a man to see a doctor. Biological material for the study is taken from the urethra by inserting into it a special sterile probe. Before the procedure, the patient is massaged the prostate and the urethra.

Accidentally detected gonococci in the smear in men with torpid (asymptomatic) course are extremely rare, however, such patients are the source of multiple infections. In addition, this category of patients, as well as those who are trying to cure themselves or simply ignore the disease, constitute a reserve for replenishment of patients with an epidemic, prostatitis, infertility and impotence. Untreated chronic gonorrhea can lead to scarring and stricture of the urethra, threatening the complete impossibility of emptying the bladder.

Therefore, if a man has stains on his underwear from minor and not disturbing secretions, in the morning the lips on the exit from the urethra slightly stick together, the urine becomes turbid, there is a slight discomfort when emptying the bladder, it is necessary to be examined urgently. Unpleasant sensations at inspection are not comparable to consequences of the started disease.

Gonococci in a smear in women with pregnancy are subject to mandatory eradication. The patient could be infected both before and during pregnancy. If the infection was latent, then pregnancy could serve as a provocation to exacerbation. The overwhelming majority of infected expectant mothers are diagnosed with chronic lesions of the lower parts of the genitourinary system. During pregnancy, a smear is tested twice for gonococci - when treated and before maternity leave. Women themselves are turning to the suspicion of the presence of gonorrhea extremely rarely - either during an acute illness with severe symptoms, or with an aggravation of severe complications. The inflammatory process in acute form with infection of a pregnant woman is accompanied by a more marked symptomatology than with chronic gonorrhea.

This disease in a pregnant woman can cause serious health disorders in her and the newborn. The child often becomes infected when passing through the mother's infected mother's pathways - a newborn of either sex develops a glenoblenorea that leads to blindness. Girls can get infected with genital organs, which will lead to gonorrheal vulvovaginitis of newborns. Sepsis of newborns can also be caused by the presence of gonococcal infection in the mother.

For a woman, this disease is fraught with complications of pregnancy, premature birth, fetal death. With chronic ascending gonorrhea, a woman often develops a habitual miscarriage.

Childbirth is a provoking factor for the spread of infection for the inner uterus.

So, if gonococci are detected in a smear, then a patient of either sex is diagnosed with gonorrhea. This disease is subject to immediate treatment from a specialist-venereologist. Otherwise, the consequences can be very sad. In addition to the genitourinary system of the gonococcus, lymphogenous and hematogenic pathways can affect not only the genitourinary organs, but also joints, musculoskeletal tissue, as well as the liver, heart, brain.

Treatment

The easiest way to treat acute gonorrhea, if the disease has passed into a chronic form, treatment can be more prolonged and multi-stage, however, provided that the patient fulfills all medical appointments and does not stop treatment with the first signs of improvement, the infection can be completely destroyed.

Gonococci are sensitive to antibiotics. Previously, penicillins were used for their eradication. Modern pathogens have become resistant to this group of drugs, so antibiotics belonging to the fluoroquinolone and cephalosporin series are often prescribed. The main principles observed in the treatment of gonorrhea infection are the choice of the drug to which the detected gonococcus is sensitive and the selection of a single and course dose sufficient for its eradication.

Today, more and more common infection, for example, with trichomoniasis. These parasites are indifferent to antibiotics that do not penetrate the membranes of the cytoplasm of Trichomonads. When combined with these parasites, phagocytosed gonococci, preserved in Trichomonas after treatment, can be a source of recurrent gonorrhea. Therefore, in this case, a complex treatment is needed.

Premature interruption of the course of therapy is not allowed, because even in the absence of symptoms gonococci can remain in the body, acquire resistance to the previously used drugs and with subsequent relapse they will be virtually impossible to eradicate. After a therapeutic course, a thorough examination is mandatory. Criteria for successful treatment are absence: symptoms of infection and gonorrhea in a smear from the urethra, cervical canal and anal opening.

Necessarily it is necessary to pass inspection to all sexual partners of the ill individual. Female children are to be examined if gonorrhea is found in a smear from one of the parents.

The patient and his relatives must follow the rules of personal hygiene.

Patients are advised to take a lot of fluids, exclude spicy food and alcohol during treatment, limit physical activity, exclude trips to the pool, sauna, swimming in open water.

Immunity after the transferred infection does not arise, and you can be infected as many times as you like. The most reliable method of preventing infection is barrier contraception (condom).

To reduce the risk of infection after unprotected sexual intercourse, the following actions can help: immediate emptying of the bladder and the toilet of the external genitalia using soap, an antiseptic, eg miramistin or chlorhexidine. They can be used within two hours after sex, nevertheless, these methods do not give a guarantee of avoiding infection, their effectiveness is reduced in geometric progression to the time that has passed since the moment of unprotected contact. Because of the difference in the anatomy of the genitals, such measures are more effective for males.