9- Gonorrhoeal infection in women, complcated forms of infection

Describe gonorrhoeal infection in women

• 50% are asymptomatic and remain unnoticed

What is the primary site of infection

• endocervical canal

• Increased vaginal discharge, dysuria, intermenstrual bleeding, menorrhagia

• Purulent cervical discharge with erythema and oedema

What are the symptoms

• Increased vaginal discharge,

• dysuria,

• intermenstrual bleeding,

• menorrhagia

• Purulent cervical discharge with erythema and oedema

What are the complications

• Salpingitis or pelvic inflammatory disease

  • Due to ascendion

  • In 10-20%-> long term infertility, chronic pelvic pain, ectopic pregnancy

• Gonorrheic perihepatitis

  • Fitz-Hugh-Curtiz syndrome

What is the clinical manifestation of pelvic inflammatory disease

vary and include

• lower abdominal pain,

• adnexal tenderness,

• elevation of the ESR,

• leukocytosis

• fever

What is the clinical manifestation of Gonorrheic perihepatitis

• Inflammation of adjacent peritoneal area

• Infrequent complciation with symptoms of PID + pain int eh right upper quadrant that mimics acute cholecystitis

What are extragenital gonorrhoea

• pharyngeal G

• rectal G

• arthritis gonorrhica

  • moonoarthritis

• Gonococcal opthalmia

  • purulent conjunctivitis

• opthalmia neonatorum

What is pharyngeal gonorrhoea

• Usually asymptomatic,

• important source of urethral gonorrhoea in MSM

What is rectal G

• Asymptomatic in 50% of patients

• Gonococcal proctitis-

  • rectal discharge,

  • anal pruritus,

  • bleeding,

  • tenesmus,

  • constipation

What is opthalmic neonatorum

• Gonococal infection in newborns is caused by inoculation during delivery through an infected birth canal, presents with purulent conjunctivitiy

  • Preventative application of antimicrobial ointment immediately after birth