Urogenital clamidiosis

Description:

Urogenital clamidiosis - one of the most widespread diseases, sexually transmitted. Chlamidia uretrita meet much more more often than gonorrheal, and can complicate a current of gonorrheal uretrit (multi-infection). More than a half of cases of diseases of not gonorrheal uretrita is caused by Chlamydia trachomatis microorganism. It is the most widespread causative agent of inflammatory diseases, sexually transmitted. In the developed countries Chlamidia uretrita meet by 3 times more often than gonorrheal, however for the first time from urinogenital ways of a chlamydia were allocated only in the late fifties our century.

Symptoms of Urogenital clamidiosis:

Cardinal distinctions in clinic of various not gonorrheal uretrit, including Chlamidia etiology and gonorrhea are not available. Chlamydias strike the same cylindrical epithelium, as gonokokk, and cause emergence of the same clinical forms of urogenital diseases. Nevertheless some distinctions between Chlamidia and gonorrheal uretrita exist. First, the incubation interval at a Chlamidia urethritis, as a rule, longer, than at gonorrhea, also makes 10-14 days. Secondly, subjective feelings of patients at Chlamidia uretrita less acute, than at gonorrhea, and such uretrita can sometimes proceed even asymptomatically. From complaints at Chlamidia uretrita an itch in an urethra, moderate allocations and insignificant gripes usually meet at an urination while more expressed symptomatology is characteristic of gonorrhea: pains, gripes, plentiful allocations from an urethra. Thirdly, the nature of such allocations differs. If at a Chlamidia urethritis usually there are not too expressed mucous or mucopurulent allocations, then at gonorrhea these allocations, as a rule, purulent and plentiful.

All these distinctions have very relative character. They are changeable and can only assume existence of this or that infection, i.e. without laboratory diagnosis, only on the basis of a clinical picture the diagnosis of a Chlamidia urethritis cannot be made. Perhaps torpid course of gonorrhea reminding a Chlamidia urethritis and, on the contrary, sharply proceeding clamidiosis with the plentiful purulent discharges and gripes inherent in gonorrhea.

Reasons of Urogenital clamidiosis:

Chlamydia - a microorganism so peculiar that it was carried to separate family in classification of bacteria. The chlamydia represents a gram-negative bacterium with the unique life cycle which is not found more in the nature. This microorganism is intermediate as if between bacteria and viruses and combines their main characteristics. So, having both nucleic acids (DNA and RNA), the cell wall corresponding to gram-negative bacteria, having ability to binary division in the course of reproduction and sensitivity to antibiotics, the activator possesses also those signs which consider inherent only in viruses. It is possible to carry the following to such properties of a chlamydia: first, they cannot independently function out of cells owners as have own no ATP and are energetically dependent on other cells in which they only also can live, i.e. are "power parasites". One more property of a chlamydia which is pulling together them with viruses is connected with this circumstance, - on artificial mediums of a chlamydia cannot grow, the live cellular culture is necessary for their life activity; secondly, one of forms of existence of a chlamydia reminds a dispute which is metabolic inactive, insensitive to action of antibiotics, is incapable of reproduction; thirdly, by the sizes chlamydias are commensurable with viruses.

Treatment of Urogenital clamidiosis:

As Chlamydia trachomatis — an intracellular parasite, the choice of drugs is limited to those which are capable to get in a cell. The antibiotics containing the macrocyclic lactonic ring connected with one or several carbon remains in a molecule belong to macroleads. Distinctions in chemical structure of macroleads are not so essential, but their physical and chemical and biological qualities differ. 14-chlenny macroleads — erythromycin, Oleandomycinum, кларитромицин, рокситромицин; 15-chlenny — azithromycin; 16-chlenny — джозамицин and Spheromycinum. Macroleads of "new generation" slightly differ from erythromycin on an action spectrum, but have incomplete cross stability with it, the improved pharmacokinetics and the raised safety profile.

Choice drug in treatment of urogenital clamidiosis according to the last international standards (WHO recommendations, the European recommendations of 2010 — European guideline for the management of Chlamydia trachomatis infections) is azithromycin — a single dose of the corresponding dose; or the 7-day rate of doxycycline is applied. Other macroleads, ftorkhinolona are alternative. The profile of safety allows to apply azithromycin at treatment of pregnant women (category B on FDA). For other macroleads not enough evidential data (S-category, or safety level on FDA is not established) that it was possible to recommend them at pregnancy.

In addition to an antibiotic, the scheme of treatment of clamidiosis sometimes includes antifungal drugs (fluconazole), immunomodulators (interferon); in the presence of plentiful allocations from an urethra use also local antimicrobic drugs).

To obligatory inspection and, if necessary, treatment, all partners who were in sexual contact with the patient are subject. During treatment and dispensary observation sex life is not recommended, or condom is used. During treatment reception of alcoholic beverages is prohibited; it is recommended to limit the use of dairy products also.