Gonoblennorea

Gonoblennorrhea (acute conjunctivitis caused by gonococcus), belongs to very serious eye diseases. Gonoblennorrhea was especially frequent in neonates in prerevolutionary Russia and often ended in blindness. Currently, this severe eye disease in newborns is extremely rare and is observed in cases where childbirth occurred not in the maternity hospital and prevention was not carried out.

Gonoblennarea develops when a conjunctive secretion contains the gonococcus Neisser. From the mucous membrane of gonococci can spread and lead to the generalization of infection with the development of diseases such as gonits, myositis, endocarditis, etc.

Symptoms of the gonoblenorei

There are gonoblennorrhea of newborns, children and adults.

Gonorrhea of newborns occurs, as a rule, on the 2nd-3rd day after birth. Infection occurs during the passage of the fetus through the birth nougat of a mother who has gonorrhea. Infection can also occur through childcare items and give a later illness (later 2-3 days).

At the beginning of gonoblennorei, the eyelids become swollen, become very dense, so that they are difficult to open for inspection. Conjunctiva sharply hyperemic, edematic and easily bleeds. The discharge is meager, serous, with a small amount of blood. After 3-4 days, the eyelids become less dense and a profuse purulent discharge of yellow with a greenish tinge appears. In a smear of pus under a microscope, gonococci are found.

The great danger of gonoblenaire lies in the defeat of the cornea. The ocular conjunctiva of the eyeball squeezes the marginal loop net, disrupts the nutrition of the cornea. In the epithelium, which, moreover, is macerated due to the presence of a copious purulent discharge, purulent ulcers easily result, leading to perforation, and subsequently to the formation of a coarse whitening with a decreased vision or even loss of the eye. Prior to the introduction of sulfonamides and antibiotics into medical practice, the disease lasted up to 1.5-2 months, and complications from the cornea, often resulting in the formation of a thorn and often blindness, were observed.

Gonoblennorei adults is more severe than in newborns, more often affects the cornea, sometimes accompanied by fever and joint damage. Infection occurs when drifting a secret from the urethra to the patient himself, suffering from gonorrheal urethritis. The infection is also inflicted on medical personnel serving gonorrhea patients, for example, when examining a patient, when opening a fetal bladder, when examining a child suffering from gonococcal conjunctivitis, etc.

Pediatric gonorrhea due to the severity of the flow of mite than gonoblenoreya adults, but heavier than newborns. There is a children's gonoblenaire, as a rule, in girls. Infection occurs from a sick mother when the rules of personal hygiene are not respected.

The diagnosis of gonoblenaire is finally established after bacteriological examination of the smear from the conjunctiva; Gonococci are located inside and outside the cell.

Treatment of the gonoblenorei

Treatment of gonococcal conjunctivitis consists in the general and local administration of large doses of sulfonamides and antibiotics - washing the eye with a solution of boric acid, the installation of eye drops (okazil, floxal or penicillin) 6-8 times a day. Systemic treatment is carried out: a quinolone antibiotic 1 tablet 2 times a day or penicillin intramuscularly. In addition, appoint an installation of anti-allergic or anti-inflammatory drugs (spersallerg, allergothal or tilt) 2 times a day. At the phenomena of keratitis also instill vitasik, carpozinum or taufon 2 times a day.

In newborns, local treatment is the same as in adults, and systemic - the introduction of antibacterial drugs in doses according to age.

Prevention

Preventive maintenance gonoblenorei newborns consists in sanation of mother in an antenatal period. Immediately after birth, the child wipes the eyelids with a cotton swab soaked in a 2% solution of boric acid, and a 2% solution of silver nitrate is added to each eye (Matveyev-Kreda method). Recently, antibiotics and sulfonamides have been used for prevention. Freshly prepared penicillin solution (30 U.S. ED in 1 ml of isotonic sodium chloride solution) or 30% solution of sulfacyl sodium is instilled three times for 1 hour after preliminary treatment of the eyelids with a 0.02% solution of furacilin. Prevention of gonorrhoea in adults and children is the careful observance of the rules of personal hygiene.