Gonococcal runny nose

Gonococcal rhinitis occurs when the mucous membrane of the nose is invaded by gonococci in newborns during childbirth through an infected birth canal. It can be combined with gnococcal conjunctivitis. It is assumed that in some cases the conjunctiva of the eye is exposed to the primary infection, and then the infection through the SM and the lacrimal-nasal canal reaches the mucous membrane of the nose and gives rise to gonococcal rhinitis. A retrograde route of infection is also possible - from the mucous membrane of the nose to the conjunctiva through the lacrimal ducts.

Symptoms are divided into local and general. Local symptoms include abundant purulent nasal discharge of a viscous consistency, greenish color with an admixture of blood, hyperemia and swelling of the tip and wings of the nose, as well as the upper lip. In infants, shortness of breath is observed due to impaired nasal breathing and severe difficulty sucking. Purulent discharge dries into dense crusts, causing blockage of the nasal passages; spreading to the skin of the vestibule of the nose and upper lip, they provoke the formation of cracks and ulcers. Intense hyperemia, infiltration and ulceration foci are found on the mucous membrane. General symptoms are manifested by fever and pronounced general poor condition of the newborn, caused by intoxication, impaired breathing and nutrition (decrease in the child's body weight), as well as the rapid occurrence of complications.

The evolution of the disease is hyperacute, since it occurs on the first day after birth. Sometimes the process develops subacutely with a tendency to chronicity of the disease, like chronic gonococcal urethritis, manifesting itself as a symptom of "nasal drop", as is the case with chronic urethritis. Chronic gonococcal rhinitis can last for several months if the child does not die during the first 2-3 weeks from the acute process.

Subacute and chronic forms of gonococcal rhinitis in adults can proceed mostly asymptomatically and manifest only as a symptom of "morning drop". Oropharyngeal forms are also possible, which most often proceed "under the flag" of banal pharyngitis, are difficult to diagnose and are cured spontaneously.

Complications of gonococcal rhinitis in infants by frequency in descending order can be arranged as follows: purulent gonococcal ophthalmitis, pulmonary, gastrointestinal and ear complications, which in the pre-antibiotic period led to the death of the child. In rarer cases, in which spontaneous recovery occurred, synechiae, cicatricial changes, atrophy of the mucous membrane, and often hyposmia remained in the nasal cavity. Nowadays, due to the use of antibiotics, severe forms of gonococcal rhinitis with the indicated consequences and complications are practically not observed.

The prognosis for the life of a newborn is favorable with timely and effective treatment. In functional terms, with ineffective and untimely treatment, when pronounced pathomorphological changes occur in the nasal cavity, it is unfavorable: massive synechiae and scars cause atresia of the nasal passages and deprive the patient of normal nasal breathing.

Treatment is divided into local and general. Local treatment, along with the above methods, involves frequent irrigation of the nasal cavity with solutions of penicillin antibiotics, as well as various antiseptic and disinfectant solutions (miramistin, chlorhexidine, nipemidic acid). General treatment is carried out according to the appropriate schemes with aminoglycosides (gentamicin, spectinomycin), amphenicols (chloramphenicol), macrolides and azalides (azithromycin, oleandomycin, erythromycin, etc.), non-nicillin drugs (amoxicillin, ospamox, flemoxin, etc.), and immunomodulatory treatment is also prescribed (methylglucamine acridone acetate, cyclopheroi, etc.).

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