And this week I’m continuing to look at sexually transmitted diseases. Especially in the summer, they become extremely important along with the knowledge to protect against them. This time, the gonococcal infection comes to the fore. Gonococcal bacteria (Nesseria gonorrheae) affect both sexes equally and are transmitted to sexual partners by direct contact with any type of mucous membranes – the mouth, anus, penis and vagina. The gateway then determines what the exact symptoms would be in the event of an infection – pharyngitis, proctitis (inflammation of part of the large intestine), urethritis or infection of the female genital organs. Today, the disease most often occurs in men who have sex with men (MSM), people with promiscuous behavior who do not use barrier contraceptives, and in socially declassified environments. Infection with gonococcus does not necessarily lead to the development of disease. In half of the cases, carriage in women turns out to be asymptomatic, and rectal and pharyngeal carriage does not lead to a manifested clinical picture in more than ¾ of such cases. These cases are of great importance for the spread of the infection. The most common clinical course in women is associated with symptoms suggestive of cervicitis (inflammation of the cervix). Intimate discomfort, pain low in the abdomen or pelvis, painful sex (dyspareunia) and purulent discharge are felt. Urethritis is also a common manifestation of gonococcal infection with the following symptoms: burning and pain when urinating, swollen and reddened part of the urethra and discharge of purulent matter again. Frequent trips to the toilet for small needs and the feeling of residual urine also accompany urethritis. Infection of the oral cavity occurs in rare cases (up to 20%) after performing oral sex (fellatio or cunnilingus), and diarrhea, anal bleeding and purulent discharge, perianal pain and incomplete defecation a few days after unprotected anal sex points to ano-rectal infection. If the symptoms described above are present in you or your partner, it is recommended to refrain from intimate contact without barrier methods of protection and encourage consultation with a doctor, because untreated this infection leads to unwanted consequences. If left untreated, the infection can ascend (ascend) through the female genital tract and affect the fallopian tubes. The narrowest part of the fallopian tubes is their beginning, which is the first on the path of infection. The lumen of 1-2 mm is quickly obturated (clogged) by the swelling and the inflammatory infiltrate, which is the most unfavorable complication of gonococci – sterility. The risk of tubal obstruction after a single episode of salpingitis is about 12%, 35% when the infection is repeated, and more than 75% after 3 such episodes. NEWS_MORE_BOX Another complication is gonococcal infection during pregnancy, which can lead to premature rupture of the amniotic sac, premature birth and chorioamnonite (inflammation of the amniotic membranes).The newborn becomes infected during birth, passing through the infected birth canal. In the early neonatal period (the first 7 days after birth), the gonococcus affects the baby’s eyes with the development of conjunctivitis. In such a case, administration of 0.5% erythromycin solution or 1% tetracycline solution as local antibiotic therapy is recommended. What has been presented so far shows the need for the right therapy against gonococcus. It is an antibiotic treatment that depends on whether there is another concomitant sexually transmitted infection and on the resistance of the microorganism to antibiotics. Gonococcus has a natural resistance to vancomycin, lincomycin, colimycin and trimethoprim, therefore it is considered a mistake to use it in gonococcal infection. There are two strains of microorganisms according to their antibiotic resistance: NGPP (Neisseria gonorrheae, producing penicillinase) and NGRT (Neisseria gonorrheae, resistant to tetracycline). The assessment of further treatment is justified after carrying out an antibiogram – a study that shows which antibiotics the microorganism is sensitive to. At a low risk of NGPP (provincial areas), a single dose of amoxicillin 3 g is recommended, and at a high risk of NGPP (large cities), intramuscular administration of ceftriaxone 500 mg is used. In the case of a mixed sexually transmitted infection (usually with chlamydia), after the above-mentioned therapy, a follow-up course for a minimum of 10 days with tetracycline, for example doxycycline 100 mg 2 times a day, is necessary. Treatment of the partner(s) is also recommended. Penicillin is usually used in pregnant women with gonococcal infection, and ceftriaxone or erythromycin in the presence of NGPP. This article is intended to increase your health culture and does not encourage self-medication. In the presence of gynecological symptoms, I always recommend consulting a professional specializing in obstetrics and gynecology.which indicates which antibiotics the microorganism is sensitive to. At a low risk of NGPP (provincial areas), a single dose of amoxicillin 3 g is recommended, and at a high risk of NGPP (large cities), intramuscular administration of ceftriaxone 500 mg is used. In the case of a mixed sexually transmitted infection (usually with chlamydia), after the above-mentioned therapy, a follow-up course for a minimum of 10 days with tetracycline, for example doxycycline 100 mg 2 times a day, is necessary. Treatment of the partner(s) is also recommended. Penicillin is usually used in pregnant women with gonococcal infection, and ceftriaxone or erythromycin in the presence of NGPP. This article is intended to increase your health culture and does not encourage self-medication. In the presence of gynecological symptoms, I always recommend consulting a professional specializing in obstetrics and gynecology.which indicates which antibiotics the microorganism is sensitive to. At a low risk of NGPP (provincial areas), a single dose of amoxicillin 3 g is recommended, and at a high risk of NGPP (large cities), intramuscular administration of ceftriaxone 500 mg is used. In the case of a mixed sexually transmitted infection (usually with chlamydia), after the above-mentioned therapy, a follow-up course for a minimum of 10 days with tetracycline, for example doxycycline 100 mg 2 times a day, is necessary. Treatment of the partner(s) is also recommended. Penicillin is usually used in pregnant women with gonococcal infection, and ceftriaxone or erythromycin in the presence of NGPP. This article is intended to increase your health culture and does not encourage self-medication. In the presence of gynecological symptoms, I always recommend consulting a professional specializing in obstetrics and gynecology.