Rectal gonorrhea

Description:

Damage of a rectum of a gonococcal infection. For the first time gonorrhea of a rectum was described by Hecker in 1801, and in 1884. Boom. Messages of domestic and foreign authors confirm increase of incidence in the last decades of rectum gonorrhea, especially at women and girls, men can have a gonorrheal proctitis also. After introduction to therapy of antibiotics the frequency of damage of a rectum unlike other complications of gonorrhea did not decrease. The gonorrheal proctitis at women and girls is combined with defeat of urinogenital bodies and develops more often for the second time as a result of pus flowing from a genital tract at defecation or at rectal sexual contacts. The gonorrheal proctitis occurs at 7% of male heterosexuals sick with gonorrhea, at 12,5% of sick women and at 25% of homosexuals (WHO, 1980). According to other authors, gonorrheal proctites are observed at 30 - 63% of the women sick with this infection, at 23-28% of pregnant women sick with gonorrhea, at 50% of sick girls and at 45-55% of homosexual male. Much less often rectal gonorrhea is diagnosed separately, without defeat of urinogenital bodies (2,8-5%). Besides, M. D. Mastbaum (1985) established a possibility of existence of vulval trichomonads in a rectum at women with the mixed gonorrheal and mecotic infection of an urogenital path and gonorrheal damage of a rectum, the microorganisms producing beta lactamazu are found in a rectum.

Symptoms of Rectal gonorrhea:

Complaints at 30-40% of patients are absent. The others note an itch, burning in an anus, sometimes purulent discharges on fecal masses, at sphincter cracks - morbidity during defecation. In an acute stage perianal folds are hyperemic, edematous, between them there are cracks with a purulent plaque. At a chronic proctitis sharp-pointed condylomas often expand (it is necessary to differentiate with a trichomoniasis). At survey by a rectal speculum (it is good to light a mucous membrane of a rectum with a bulb from the urethroscope) the focal hyperemia, puffiness of a mucous membrane are found, erosion with a purulent plaque are sometimes visible (the discharge of erosion and ulcers needs to be investigated on a pale treponema and on a streptobacillus of Dyukreya-Unny-Petersena). Anorectal gonorrhea needs to be differentiated with ulcer colitis, an amebiasis, an ingvinalny granuloma, shankroidy, a venereal lymphogranuloma, a Chlamidia proctitis, giardiazy, a proctitis from лекартсв [Felman, Nikitas, 1980]. At long process polypostural growths can appear. Pararectal abscess which breaks outside, in a vagina or a bladder with the subsequent burrowing can develop.

Reasons of Rectal gonorrhea:

The disease has the infectious nature. The Etilogichesky agent - Neisseria gonorrhoeae.

Treatment of Rectal gonorrhea:

The main drugs for treatment – antibiotics of a class of cephalosporins, including tsefotaksy, cefalexin, a tsefaklor, цефокситин, tsefiksy, a ceftazidime. Antibiotics of this group suppress gonorrhea symptoms at men more effectively, than the ftorkhinolona used earlier (very often at treatment of gonorrhea of a ftorkhinolonama resistance to drugs of this group is observed).

In certain cases for treatment of gonorrhea at men intramuscular injections of a tseftriakson, the antibiotic which is effectively suppressing symptoms of the most widespread types of gonorrhea are recommended. Spektinomitsin is applied in that case when bacteria caused a gonococcal infection of a rectum or penis.

Antibiotics of oral administration are ordered in the most mild cases of gonorrhea, at an early stage of development of a disease. As a rule, duration of a course of reception of antibiotics makes from forty to seventy hours. If additional treatment is required, the course of antibiotics can be prolonged up to seven-ten days.