How Do I Use Amoxicillin for Gonorrhea?

Men with gonococcal urethritis, if not treated in time, can cause seminal vesiculitis, which will affect the storage, survival and transport of sperm, and eventually lead to infertility. Gonorrhea is a purulent infection of the genitourinary system caused by Neisseria gonorrhoeae (referred to as Neisseria gonorrhoeae). It can also invade the eyes, pharynx, rectum and pelvis, as well as blood-borne disseminated infections. It is one of the common sexually transmitted diseases. . Gonorrhea is transmitted through sexual intercourse, a few can also be transmitted by patients with pus contamination, and female patients can be transmitted to the baby through the birth canal.

Basic Information

Visiting department: Department of Infectious Diseases, Urology, Andrology
Common locations: Seminal vesicle

Common causes: Neisseria gonorrhoeae
Common symptoms: Hematospermia, painful detoxification, decreased semen volume, etc.

Causes of gonorrhea seminal vesiculitis

Acute stage N. gonorrhoeae enters the urethra through the urethral orifice, invades the anterior urethral mucosal epithelial cells, and reproduces within the cells, causing acute inflammation. A large number of white blood cells gather at the site of inflammation, the bacteria are swallowed by the white blood cells, and the bacteria die and release endotoxin, resulting in necrosis of the urethral mucosa layer, which produces a large amount of purulent secretions and is discharged from the urethral opening. In the later stage, the lesion spreads to the posterior urethra, causing urethritis and prostatitis, and seminal vesiculitis can occur retrogradely through the ejaculation duct.

Clinical manifestations of gonorrhea seminal cystitis

The clinical manifestations of gonococcal infection depend on the degree of infection, the sensitivity of the body, the virulence of the bacteria, the location of the infection, and the length of the infection. At the same time, it is related to the health of the body, whether sexual life is excessive, and alcoholism.

Simple gonorrhea

Mainly manifested as acute urethritis. Patients usually develop the disease 3 to 5 days after infection, and the elderly can reach 10 days.

(1) The incubation period of acute gonococcal urethritis (acute gonorrhea) in men is 1 to 14 days, often 2 to 5 days. From the beginning, it is acute anterior urethritis, urethral swelling, itching, and slight tingling, followed by thin mucus outflow, which causes dysuria. About 2 days later, the secretion becomes sticky, the urethra is purulent, and the pus is dark yellow or yellow-green. At the same time, the symptoms of urethral discomfort increase. The swelling develops to the entire penis glans and part of the urethra. Frequent urination, urgency, and dysuria , Difficulty urinating, impaired mobility, painful erections at night. May have inguinal lymphadenopathy, redness, swelling and pain, but also suppuration. The acute symptoms are most severe in the first week. If left untreated, the symptoms will gradually decrease or disappear for about one month. Two weeks after the onset of acute anterior urethritis, more than half of the patients had urethral invasion of the urethra, manifested as urinary distress, frequent urination, and acute urinary retention. Urinary pain is characterized by pain or aggravation at the end of urination, acupuncture-like, sometimes with perineal pain, and terminal hematuria. After 1 to 2 weeks, the symptoms gradually disappeared. Systemic symptoms are generally mild. A few may have fever up to about 38 ° C, general discomfort, and loss of appetite.

(2) Chronic gonococcal urethritis (chronic gonorrhea) is called chronic gonococcal urethritis for more than 2 months. Because the treatment is incomplete, gonococci can be hidden in the urethral body, paraurethral glands, and urethral recesses to make the disease chronic. For example, when the patient is weak and suffers from anemia and tuberculosis, the condition begins chronically at the beginning. Most of them are combined infection of the anterior and posterior urethra, which invades the urethral bulb, membrane and prostate. Clinical manifestations of the urethra are often itchy, burning or mild tingling during urination, fine urine flow, weak urination, dripping urine. Most patients have a small amount of serous seal in the urethra in the early morning. If the vulva or the root of the penis is squeezed, the thin mucus often overflows. The urine is basically clear, but it has gonorrhea.

2. Seminal vesiculitis

Some patients may have no symptoms other than blood sperm, and sometimes they show painful defecation, decreased semen volume, and symptoms of chronic prostate inflammation.

Gonorrhea seminal vesiculitis examination

N. gonorrhoeae laboratory tests include smears, culture tests for N. gonorrhoeae, antigen detection, and genetic diagnosis.

Smear inspection

Take the urethral or cervical secretions of the patient for Gram staining. Gram-negative diplococci can be found in polymorphonuclear leukocytes for preliminary diagnosis. Chronic gonorrhea has fewer gonorrhoeae in the secretion and has a lower positive rate. Therefore, prostate massage fluid should be taken to improve the detection rate.

Pharyngeal smears found that Gram-negative diplococci cannot diagnose gonorrhea because other Neisseria species are normal flora in the pharynx, and further tests for atypical smear-positive symptoms should be performed.

2. Culture inspection

Neisseria gonorrhoeae culture is an important evidence for diagnosis. The culture method is a more sensitive method for patients with very mild or asymptomatic patients. As long as the culture is positive, the diagnosis can be confirmed. Before genetic diagnosis came out, culture was recommended by the World Health Organization for screening for gonorrhea The only way.

3. Antigen detection

(1) The solid-phase enzyme immunoassay (EIA) can be used to detect gonococcal antigens in clinical specimens. It is used in areas with high prevalence but cannot be used for culture or specimens need to be sent for a long time. It can be used in women. To diagnose gonococcal infection.

(2) Direct immunofluorescence test The direct immunofluorescence test was performed by detecting monoclonal antibodies to the outer membrane protein I of Neisseria gonorrhoeae, but the sensitivity and specificity of male and female specimens are not high at present, and the judgment level of the experimenter, so this experiment It is not yet recommended for the diagnosis of gonococcal infections.

4. Genetic diagnosis

(1) Gene probe diagnosis of Neisseria gonorrhoeae. The probes used for diagnosis of Neisseria gonorrhoeae are plasmid DNA probes, chromosome gene probes and rRNA gene probes.

(2) Neisseria gonorrhoeae gene amplification detection probe technology Although the method for detecting Neisseria gonorrhoeae has greatly improved the sensitivity, specificity and convenience compared with the culture method, there are still certain limitations, such as in most cases The concentration of Neisseria gonorrhoeae in need of specimens is very high. The advent of PCR technology and ligase chain reaction has further improved the sensitivity of detection of Neisseria gonorrhoeae.

5. Check for seminal vesiculitis

Feasible ultrasound or seminal vesicle angiography.

Gonorrhea seminal vesiculitis diagnosis

The diagnosis was confirmed based on medical history, clinical manifestations and related examinations.

Gonorrhea seminal vesiculitis treatment

Gonorrhea with comorbidities is generally more severe, and the drug treatment dose and the treatment time should be increased. You can do one of the following:

1. Ceftriaxone or Spectinomycin

Ceftriaxone or Spectinomycin intramuscularly.

2. Ciprofloxacin

Ciprofloxacin is administered orally, but it is contraindicated in patients with liver and kidney dysfunction and adolescents under 18 years of age.

Prognosis of gonorrhea seminal cystitis

Gonorrhea patients can be fully cured in a timely and correct manner in the acute phase. No comorbid gonorrhea is treated with a single high-dose drug and the cure rate is high; incomplete treatment can produce comorbidities, even infertility, ectopic pregnancy, pelvic inflammatory disease, urethral stricture or blindness And disseminated gonorrhea. Therefore, we should seize the opportunity to completely cure gonorrhea in the acute stage.

Gonorrhea seminal vesiculitis prevention

1. Promote knowledge of sexually transmitted diseases, promote noble moral sentiments, and prostitution is strictly prohibited.

2. Using condoms can reduce the incidence of gonococcal infections.

3. The prophylactic use of antibiotics can reduce the risk of infection. Haloperic acid or amoxicillin can be taken before and after intercourse, which can effectively prevent the infection of sexually transmitted diseases.

4. Simultaneous treatment of sex partners.

5. Patients should pay attention to personal hygiene and isolation, and forbid to share bed and bath with family members, children, especially girls.

6. Implement a system of eye drops for newborns with silver nitrate solution or other antibiotics to prevent gonococcal ophthalmia.