According to the document, gonorrhea is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It affects 200 million people per year globally. Gonorrhea has developed resistance to antibiotics and often causes complications when left untreated such as pelvic inflammatory disease and infertility. The document discusses the classification, symptoms, transmission, diagnosis and treatment of gonorrhea. It provides detailed information on the various forms and complications of gonorrhea in both men and women.

3. According to WHO, the incidence of gonorrhea is about
200 million cases per year. Currently, for gonorrhea infection has
acquired a number of features:
•reduced sensitivity of the gonococcus to traditional antibacterial
agents,
•uncontrolled use of antibiotics leads to the appearance resistant
organisms,
•become frequent the cases of detection of mixed infections,
•increases the frequency of isolation of strains of
gonococcus producing penicillinase, which leads to an increase in the
severity of the disease.
The social significance of gonorrhea due to high incidence, rapid
development of complications, leading to an increase in the
frequency of male and female infertility.
Gonorrhea is a disease whose treatment is supported by the
legislative acts, which include responsibility for the contamination
of the sexual partner, and forced treatment.

4. Gonorrhea of urogenital organs (the genital)
Extragenital gonorrhea (gonorrhea of the rectum,
pharynx, mouth, tonsils, eyes)
Metastatic (disseminated) is a complication of the
first two

5. • Gonorrhea of the lower parts urogenital tract
without complications
• Gonorrhea of the upper urogenital tract without
complications
• Gonorrhea other organs:
- eye disease (conjunctivitis, iridocyclitis,
ophthalmia);
- destruction of the joints;
- destruction of the pharynx;
- destruction of the anus and rectum;
- other destructions (gonokokkemiya,
gonococcal endocarditis,
meningitis, peritonitis).

6. •Gram-negative diplococcus Neisseria gonorrhoeae are opened
by A.Neisseria in 1879
•Diplococcus have length from 1.25 to 1.6 microns and 0.7 -
0.8 microns in cross-section is shaped like coffee beans, a
concave surface facing each other.
•Gonococcus - the main pathogenic microorganisms adapted
during evolution to destroyed mostly mucous membranes
covered with a cylindrical epithelium, resistance of which is
extremely low, and a special tropism of gonococci due to the
presence of organelles - pili possessing virulent properties.
• In the patient’s body gonococci often undergo L-
transformation after using chemotherapeutic drugs or with a
chronic disease course.

9. Optimal for the
development of
gonorrhea are the
following
conditions - pH =
7,4; temperature =
35.5 C, the CO2
content in the
environment 2-
10%.

10. On the surface of
gonococci reveals
thin tubular filaments
- fimbriae. They are
credited with the
ability of gonococci
to transmit genetic
properties, such as
antibiotic resistance,
the ability to stick to
the epithelial cells of
the owner and other
biological
characteristics.

11. In the study of
ultrathin
sections of a
gonorrhea
detected
following
morphological
components:
•cell wall
•mezosoma
•nucleoid of
DNA strands
•cytoplasm with numerous ribosomes and polyribosomes
•cytoplasmic membrane

12. Gonococci are
located mainly in
the cytoplasm of
leukocytes -
polinukleares, but
sometimes they can
be observed, and out
of cells. They do not
penetrate the
epithelial cells, and
are usually on their
surface or in the
intercellular spaces.
Gonococci are colored by methylene blue and the Gram
stain. Gram stain is required. In this painting gonococci are
stained pink.

13. household
subjects
Haematogeno
usly through
the amniotic
fluid
Infection ofinfants
Flowing from theaffected organ

14. A single contact with an infected sexual partner leads to infection in 20-30% of cases.
Contagiousness in women is much higher than in men, and amounts to 60 - 70%.
Probability of infection with gonorrhea, depending on the type of sexual
contact (contact by 1) is:
In the cervix,
rectum
70%;in the throat20-30%
In the throat
less than 2%
to urethra
20%;
from
the urethra
from
the cervix
to urethra20%
to urethra
less than 3%from
the rectum
fromthe throat

15. Gonococci primarily affect parts of the urogenital tract, lined
with columnar epithelium - the mucous membrane of cervix,
fallopian tubes, urethra, paraurethral and large vestibular
gland. When genital-oral contacts can develop gonorrheal
pharyngitis, tonsillitis and stomatitis, with genitalnoanalnyh -
gonorrheal proctitis. When a pathogen enters the mucous
membrane of the eye, including the passage of the fetus
through an infected birth canal, there are signs of gonococcal
conjunctivitis.
Vaginal wall, covered with stratified squamous epithelium is
resistant to gonococcal infection. However, in some cases
(during pregnancy, in girls and in postmenopausal women),
when the epithelium becomes thinner or becomes friable, may
develop gonococcal vaginitis.

16. Gonococci entering the body, quickly fixed on the surface of
epithelial cells with pili, and then penetrate deep into the
cells, intercellular gap and the subepithelial space, causing
the destruction of the epithelium and the development of
inflammatory reactions.
Gonorrheal infection in the body usually covered by stretch
(canalicular) from the lower parts of the upper urinary tract.
Adhesion to the surface of the sperm gonorrhea and
trichomonas in enterobiasis promote more rapid progress.
Gonococci by lymphogenous way can penetrate into the the
lymphatic vessels and nodes located above the urethra in the
genitals.

17. Entering into the bloodstream, gonococcus cause bacteremia,
rarely disseminated to various organs to form metastases
(metastatic gonorrhea). Reproduction of gonococci in the blood
stream to the development of sepsis occurs very rarely.
Gonococcal inflammation leads to the development of
degenerative processes in the submucosal layer of the urinary
organs. In chronic inflammation, cylindrical epithelium can be
transformed into stratified squamous with symptoms of
keratinization causing stricture urethra.
In response to the introduction of the causative agent of
gonorrhea in the body produces antibodies, but the immune
system is ineffective in this case. A person can be infected with
gonorrhea, and ill many times. This can be explained by the
antigenic variability of gonorrhea.

18. Transkanikulyarny
Lymphogenous dissemination
Hematogenous dissemination
Retrograde path

19. urethra
paraurethral ducts
large gland of vestibule,
the cervical canal,
vagina
the secret of the prostate, seminal vesicles, glands and urethral
lacunae
washings of the rectum
scrapings from the urethra and rectum
eyes discharge with gonoblenoree
synovial fluid of joints with lesions
Fence material produces a doctor.

20. The symptoms usually appear 3-7 days after infection,
but in some cases the incubation period increases up to
2-3 weeks.

21. cutting pains in the beginning of urination, burning,
itching
lips external foramen of urethra - sharply hyperemic,
edematous
the urethra are infiltrated
profuse purulent discharges of yellowish or greenish color,
soiling underwear
pain of suspension of urethra
painful erections
turbid from pus 1st (200 ml) serving of urine

22. pain throughout urination, pollakiuria
imperative desires to urinate
purulent discharge from the urethra, lips of external
foramen of urethra swollen, hyperemized
terminal hematuria - at the end of urination
discharged few drops of blood
with the defeat spermatic tubercle –
frequent painful erections,
gemospermiya

23. characterized by a significant
reduction of all symptoms
occurs after 3-10 days an acute
urethritis
mild itching or stinging during
urination
unprofuse, mainly morning sero-
purulent discharge
lower severity of hyperemia and
edema of urethral lips

24. moderate pain at the beginning of urination, itching
of the external foramen of urethra
lips of urethral can be a little inflamed, edematous
(morning sticking sponges)
discharge from the urethra is scarce - either in the
morning, or not
Thompson test:
1 cup - clear urine with a small amount of white
fibers
2 cup - a lot of long and short fibers

25. pain when urinating mild or absent
itching of the meatus
urethral sponge can be a little inflamed, edematous
slight discharge from the urethra (usually in the
form of "morning drop")
threads and flakes of pus are detected in a urine
analysis
especially in chronic gonorrhea
often have a variety of complications

26. Balanoposthitis -
inflammation of
the inner layer of
the foreskin and
the glans penis.
On the skin of the
penis appear to
erosion, mostly in
the bridle, there is
pain.

27. Periuretrit (cavernitis) - inflammation of loose
connective tissue surrounding the urethra.
1. restricted - formed a dense, painful infiltrate during
the urethra
2. diffuse - the accumulation of pus in the cavernous
bodies

28. Paraurethral abscess - occurs when the introduction
of the pathogen in the periurethral tissue and the
corpus cavernosum, shaped infiltrate can make it
difficult urination. Later, he is often subjected to
purulent fusion, exposing to the urethra.

29. Cooperitis - inflammation of the glands Cooper
1. catarrhal - pathological changes capture the
excretory ducts of glands
2. follicular - psevdoabstsessy formed, appears a slight
pain in gland
3. parenchymatous - in the process of parenchyma is
involved, pain increases
4. parakuperitis is characterized by the spread of
inflammatory changes on the surrounding tissue.
Determined by the fluctuation of the tumor. The
general condition of the patient deteriorated
markedly. The body temperature rises to 39C
In secret of Cooper's gland are gonococci.

31. Epididymitis - inflammation of the epididymis, usually arises as
a result of introduction of gonococci from the back of the
urethra through the ejaculatory ducts and vas in the tail of the
epididymis. Less commonly, gonococci penetrate into the
epididymis through the lymphatic vessels.
Symptoms:
1. the presence of blood in the semen
2. painful swelling of the scrotum
3. febrility
4. groin pain
5. pain during ejaculation
6. pain in the scrotum, which increases during a bowel movement
7. discharge from the urethra

32. Epididymitis

33. Epididymitis

34. Differentitis - inflammation of the vas deferens
Funiculitis - inflammation of the spermatic cord
Urethral stricture - umbilicus narrowing, usually
multiple
Prostatitis - inflammation of the prostate gland.
There is usually at the back of the urethral injury
due to contact of gonococci into the prostate through
the excretory ducts of the glands, sometimes
lymphogenous and hematogenous route.

35. Vesiculitis - inflammation of the seminal vesicle, often
accompanied by lesions of the prostate. Catarrhal
changes in the mucous membrane of seminal vesicle
accompanied by desquamation of the epithelium. In
cases of involvement in the pathological process of the
submucosal and muscular layers of the bubble wall
show a deep form of vesiculitis, accompanied by a
completed body of purulent contents. Progression of
disease leads to the development of empyema, and in
the future - and to paravesiculities. Clinical
manifestations are diverse: the itching and pain in the
urethra combined with the frequent urge to separate
urine and terminal hematuria.

37. Features of gonorrhea in women:
1. Gonorrhea in most cases of the disease does not
cause significant pain.
2. Multifocal disease: foci of inflammation exist
simultaneously in the urethra, cervix, large glands
of vestibule , and often in the rectum.

38. The forms of gonorrhea in women:
1) fresh gonorrhea of the lower urinary
tract (active, torpid, asymptomatic);
2) a fresh rising gonorrhea;
3) chronic gonorrhea of the lower urinary
tract (active, torpid, asymptomatic);
4) chronic rising gonorrhea in the acute stage, in the stage of
relative stabilization and in the stage of stabilization.
The acute stage is determined by
the symptomatic bright lesions of the uterus and appendages
(increased body temperature, changes in blood counts,
and the appearance of pain, induration and tenderness of the
internal reproductive organs). In the stage of relative
stability the changes in the internal sex organs are less
noticeable. In the stage of stabilization patients have no
complaints, but objectively observed changes in the uterus
and appendages.

40. Vulvitis and vestibulitis (Vulvovestibulitis)
-gonorrhea of the lower parts of the genitourinary system.
Vulvovestibulitis - is rare inflammatory process ,because this region is
mostly covered by stratified squamous epithelium.
Clinically: diffuse hyperemia appears in the acute stage , swelling of
the mucous membrane and secretions of pus from crypts.
Small lips swell and stick together.

41. Urethritis .
Female urethra is short (3.5 - 4 cm) and wide (1.5
times wider than the male). Glandular apparatus is
located mainly in the anterior part. Urethritis is
essentially a disease of the glands in urethra.
In acute gonorrheal urethritis the most
frequent complaints are on pain and
burning during urination. But after a few days,
these phenomenons are much smaller.
In chronic urethritis complaints are usually absent.
Clinically appears hyperemia and swelling of
the urethral sponges.
Urethra is infiltrated , palpation is painful.

43. Paraurethritis.
Paraurethritis is usually asymptomatic. Gonococci often
breed on the bottom of lacunar stroke, because it is
covered with columnar epithelium and the walls -
stratified squamous epithelium.
External opening of lacunar stroke is an extra- or
intrauretral in the form of point. There is congested spot
around this point. Purulent discharge appears after
pressing on the mouth of the duct. When the mouth of
the duct closes by purulent discharge and peeling
epithelium an abscess is formed . Periodically, it can be
emptied and recurring, remaining a constant focus of
infection.
If paraurethritis becomes chronic, hyperemia around the
lacunar strokes is reduced. Gonococci in the cavity of
the lacunae retain virulence during a lot of months or
even years. That’s why paraurethritis can exist longer
than urethritis.

44. Bartholinitis - inflammation of the large vestibular glands, often occurs secondarily,
after 2 - 3 weeks after infection, but it happens and primarily.
There are six forms of gonorrheal lesions of vestibular glands.
1. Surface canaliculitis develops after penetration of the pus, flowing from the
urethra and cervix to the vulva, into the gland. In this form the peripheral part of the
excretory duct is affected.
2.Сanaliculitis affects to the whole excretory duct. The duct thickens due to small
cell infiltration. It is painful on palpation.
3. Nodose bartholinitis occurs in patients with chronic gonorrhea as a result of partial
substitution of infiltration by connective tissue. Tight, usually painless knot is felt in
place of the gland and its duct.

45. 4. False abscess occurs after obstruction of the excretory duct and congestion of
purulent secretions behind the mouth of the duct. The excretory duct stretches
and compresses the gland, but does not destroy it.
Painful, fluctuating tumor is determined on palpation, this tumor locates in the
lower third of the genital labia majora. The skin over the protrusion is
hyperemic . Quite often can be a low-grade fever of the body. Patients complain
on pain in genital organs. False abscess may spontaneously opened, pus
contents breaks through the duct or the thinning mucous membrane on the inner
surface of the labia minora. After that, swelling, hyperemia and deformity of the
labia disappear. However, over the time the disease can recur.

46. 5.True abscess develops in the case when pyogenic bacteria
join to gonorrhea , when there is a mixed infection. There is
a purulent fusion of the gland and surrounding connective
tissue.
Clinically: hyperemia, swelling, severe pain of small and
large labia, increase of groin lymph nodes. There is high body
temperature, weakness, patients can not walk. When
the abscess softens the pus breaks through, like a false abscess.

47. 6. Excretory duct cyst is formed by the obliteration of the outside of
the duct of Bartholin’s gland, when the infection has disappeared. The
duct is stretched by the gland’s secret. The part of labia majora
protrudes in the localization of affected Bartholin’s gland. Tumor is
round, painless, fluctuating. The size of tumor is like a pea.

48. Vaginitis
The true gonorrheal vaginitis develops in pregnant ,women at
menopause (in thinning of the vaginal epithelium) and in girls who
have very loose epithelium and does not contain glycogen.
Complaints are on the profuse discharge, itching and burning in the
vulva. Sometimes granular eruption can be identified with the help of
palpation . This granularity is due to inflammatory infiltration of the papillary
layer. Also it is marked accumulation of purulent discharge in the rear arch .

49. Endocervititis.
Inflammation of the cervix usually occurs initially.
In fresh process the cervix of uterus is swelling,
hyperemic. There are profuse mucous discharges from the cervix
. Around the mouth there is a bright red surface erosion, which
is then covered with the growing columnar epithelium.
In the chronic stage, the cervix is ​​less swelling, discharges are not
so profuse.

50. Endometritis.
The penetration of gonococci into the uterus and the development of
endometritis may manifest by symptoms of lesions of the body (body
temperature 38 - 39C, the appearance of fever, the occurrence
of cutting pain in the abdomen, the sacrum, legs).Discharge from
the gender gap are abundant, fluid, pus. Regular menstruation occur
prematurely, they are heavy, long-term. At gynecological
examination is determined by two-handed painful enlarged uterus of
mild consistency. Many patients have increased ESR with
normal white blood cell count. In chronic endometritis patients have
complaints rarely. Body temperature is usually normal, but it happens.
Endomyometritis (Endomyomethritis). When the inflammation of
the endometrium extends to the muscular layer of the uterus occurs
endomyometritis. Symptoms of acute endomyometritis are the
same as endometritis, but is more pronounced.
Rising gonorrhea

52. Salpingoophoritis
In the acute stage of the desease, usually in purulent oophoritis, general condition
is deteriorating : there is a high body temperature, rapid pulse, loss of appetite,
nausea, and vomiting. Dry tongue , coated. The pains are often cramping , are
accompanied by fever. In the formation of piosalpinks the pain intensify. There are
bloating, delayed stool.
In some patients who underwent salpingoophoritis, the disease becomes
chronic. Patients concerned about constant aching pain in the abdomen, bloating,
constipation, decreased libido, impaire reproductive function.

53. Peritonitis (Peritonitis).
Propagating through the mucosa, gonococci with purulent
contents fall in the pelvic peritoneum through
the ampullar end. There are pelvioperitonitis, which is a form
of local peritonitis, and inflammation of the
peritoneum beyond the pelvis - the lower and upper floors of
the abdominal cavity, corresponding to generalized
peritonitis. Diffuse gonorrheal peritonitis is rare
and usually ends in recovery.
The disease begins abruptly, but the symptoms of acute
abdomen are less pronounced than in
other septic inflammation of the
peritoneum. Peritoneal effects last no longer than 7
days (average2-3 days) and quickly subside. The body
temperature is high. With the progression of this process
the heart failure may be observed, the fall in blood
pressure, intestinal paresis. There may come a death.

54. Congestion in the pelvic organs that develop during pregnancy,
determine the identity of gonorrhea in pregnant women. Despite the
lack of complaints, the majority of patients can be
detected very pronounced inflammation in the
urethra, cervix, rectum, etc.
The cervix is affected gonococcus in all pregnant women, the
urethra - in 74%, the uterus - in 20.5%, the rectum -
at 16.35%,Bartholin gland - at 7.45%.
Gonorrhea in 6.5-10% of pregnant women leads to spontaneous
abortions and in 6.3 - 12% is a cause of preterm birth.
Treatment:
Drugs of choice during pregnancy are some of
the cephalosporins,macrolides,
spectinomycin, benzylpenicillin. Tetracyclines are contraindicated,
fluoroquinolones, aminoglycosides.
The criteria for cure are:
-the absence of subjective and objective symptoms
-negative results of microscopy and culture studies

55. In girls, due to age-related anatomical
and physiological features the
clinical picture
of gonorrheal process is other than
those in women.
Sources of infection:
-are most often parents or other
persons who are caring for a child.
- Rarely become infected through
sex with an attempt to rape.
- Rarely can be
transmitted gonococcal infection to
the fetus by hematogenous way or
through placenta.
Incubation period is up to 3 days.
Gonorrhea among girls, as well as in
women, is a multifocal disease.

56. Clinical picture:
manifestations
of gonorrhea depend on the state
of the organism and the virulence
of gonococci. In
acute vulvovaginitis, the skin of
the labia minora and majora, the
vestibule mucous membrane
are swollen, hyperemic and are
covered by purulent mucous
secretions , the clitoris and
the hymen is swollen. Purulent
discharge collects in the posterior
fornix of vagina. Mainly the front
third of the urethra is affected.
Chronic gonorrhea in girls is rare
and is only 6%.

57. Gonococci fall into the rectum with purulent secretion from the
gender gap in women and girls, or after perverted sexual
act with homosexual male. Only the distal part of rectum and the
region of external sphincter of the anus are affected,
where gonococci have favorable conditions for
existence. Gonorrheal proctitis rarely occurs acutely.
The clinical picture of acute suppurative proctitis:
- Pain with bowel movements or itching in the anus, in the formation
of cracks and erosions in the external anal sphincter may be an
admixture of blood to feces;
-circumference of the anus is hyperemic.
In chronic and fresh torpid forms of proctitis there are no
complaints from patients .

58. Gonococcal pharyngitis is caused by oral-
genital sex, thus there is infection of the throat and
other organs of the mouth: the tonsils, gums,
tongue, palatine arches with the tongue.
Clinical picture:
-often asymptomatic.
Sometimes, patients can be confusing by dryness in
the throat, pain, aggravated
by swallowing, "tickle" in the throat.
On examination congestion and swelling of the
mucous membrane of the oropharynx may
be detected .Sometimes individual follicles, an
increase of regional lymph nodes and low-grade
fever can be found . Sometimes there
is hoarseness. The inflammatory process may
spread to other parts of the oral mucosa, soft palate,
gums. Gonococcal gingivitis may be accompanied
by bleeding gums and the appearance of halitosis.

59. This is a common manifestation of gonococcal infection of
newborns
(gonococcal conjunctivitis, iridocyclitis, gonococcalophthalmia neo
natorum), but also meet in adults. Newborns are infected during
passage through the birth canal, but maybe in utero infection of the
amniotic fluid.
The incubation period ranges from 2 to 5 days. The disease may
occur on the first day of life.

60. The clinical picture of eye gonorrhea :
-swelling of both eyelids, photophobia, mitigation age 3-4
days, the appearance of copious purulent discharge,
which accumulates at the edges of the eyelids.
The period of the flow of pus has a duration of two
to three weeks. After this period, a period
of papillary hypertrophy, there is a decrease in the
amount of pus and its liquefaction, edema and
hyperemia of the conjunctiva is also reduced, and
papillary growths appear .
Neonatal ophthalmia develops after the deep penetration
of the inflammation to the eye, it affects the
inner shell. This may be result in the
subsequent scarring and vision loss.

61. Gonococci penetrate into the bloodstream in most cases of gonorrhea. But in the
blood gonococci are killed immediately by the influence of factors of natural
immunity. Only in relatively rare cases the hematogenous dissemination of
gonococci occurs, when they are multiplying in the blood (gonokokkemiya),
recorded in various organs and tissues, causing destruction of the joints,
endocardium, meninges, liver (abscess, perihepatitis), and skin.
Disseminated gonorrheal infection occurs in two main forms.
1) A heavy, sometimes fulminant sepsis.
- high fever, tachycardia, chills and heavy sweats, and various skin rashes.
2) Easy process
- The phenomenon of toxemia expressed slightly, febrile reaction is moderate or
short-term, and the clinical picture is dominated by joint destruction.

62. The main methods of laboratory diagnosis of gonorrhea - smear and
bacteriological, are aimed at detecting the pathogen. The identification is carried
out in three gonorrhea signs: diplococcus, intracellular location, gram-negative
microorganisms. Due to the high potential for variation under the influence of
adverse environmental effects is not always possible gonococci detected by
microscopy, the sensitivity and specificity of which consists of 45-80% and 38%
respectively.
Bacteriological method is more suitable . Planting material produced in a
specially created artificial culture media. The sensitivity of bacteriological
methods - 90-100%, specificity - 98%.
The men take swabs from the urethra and rectum in women - from the urethra,
vagina and rectum.
Other methods of laboratory diagnosis of gonorrhea (immunofluorescence,
ELISA, DNKdiagnosis),they are rarely used.

63. A. Bacterioscopy (in acute form of gonorrhea
pathogen is largely confined to leukocytes, and in chronic form -
extracellularly).
N - neutrophilic leukocytes.
Gn - gonococci, filling the inside white blood cells/

64. 2 .Bacteriological examination, the definition of sensitivity to
antibiotics.
3. Immunofluorescence assay (IFA).
4. Immunofluorescenceassay (IFA). With this diagnostic
method can identify the gonococcus in the early stages of the disease,
it is important incases where there is a combination of gonorrhea and
other microorganisms, such as pale treponema (syphilis).
5. Molecular methods: polymerase chain reaction and ligase chain
reaction (PCR, LCR).
PCR is a DNA analysis for gonorrhea - a method of genetic
identification of gonorrhea. This method has the highest sensitivity
and specificity.

65. Treatment of uncomplicated gonococcal infection:
Suggested modes are:
Ceftriaxone (Rocephin) / m 250mg once
Ciprofloxacin 500 mg orally once
Cefixime per os a single dose of 400 mg
Alternative modes:
Ofloxacin 400 mg per os once
Spektomitsetin (macrolide) 2.0 V / m for single men, 4.0 V / m for
women.
The drug is indicated for intolerance of quinolones and cephalosporins.
It is also used:
Tseftizoktsim-500 mg / m once
Cefotaxime (klaforan) 500 mg / m once
Tsefotetan 1.0 / m once
Cefoxitin 2.0 V / m once
Cefuroxime aksetil 1,0 per os once
Prokstil cefpodoxime 200 mg per os once
Enoksatsin 400 mg per os once
Norfofloksatsin 800 mg per os once

66. Treatment of complicated gonorrhea
Recommended mode
Ceftriaxone is 1.0 V / m or / once a day
alternative modes of
Cefotaxime or Tseftizoksim 1.0 in / in 8 hours
If intolerance B-lactam ntibiotics, Spectinomycin 2.0 V
/ m after 12 hours.
Treatment is carried out before clinical signs
of improvement, and24-48 hours after that,
then, before the expiration of a full week since the
beginning of treatment, it is used the
following modes: Cefixime 400 mg or
ciprofloxacin 500 mg per os twice a day

67. Treatment of gonococcal infections of the eye:
Ceftriaxone--1.0 g / m once.
Local treatment: 1% - th solution of silver nitrate,
1% tetracycline eye ointment th,
0.5% eritromitsinovaya eye ointment.
Treatment of gonococcal meningitis
and endocarditis:
-I / O high-dose Ceftriaxone: 1-2,0 in 12 hours. The
treatment lasts10-14 days, meningitis, endocarditis, up
to 4 weeks.

68. Treatment of neonatal ophthalmia
Ophthalmia neonatorum requires isolation of the
sick child for 24 hours of starting treatment.
-Ceftriaxone at a dose of 25-50 mg / kg / d / or
/ m in a single dosefor 7 days.
Cefotaxime--25-50 mg / kg / m every 12
hours. (With disseminated gonococcal infection in
neonates).
locally:
to hourly rinsing with saline until the termination
of discharge.
-solution of Na Cl 0,9%

69. Prophylaxis of ophthalmia neonatorum:
Prevention is for all of preterm infants. It is done
immediately after birth.
Silver nitrate, 1% aqueous solution of a single
dose of 2-3 drops in each eye.
Erythromycin 0.5%, 1% eye ointment once
Tetracycline 1% eye ointment

70. Ceftriaxone (Rocephin) / m single 125 mg (body
weight less than 45kg)
Alternative modes:
Spektomitsetin 40 mg / kg dose.
And children weighing over 45 kg, are
treated like an adult.