DISEASES OF FEMALE GENITAL ORGANS : GONORRHEA IN GIRLS - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Usually the girls observed the primary vulvitis and vaginitis, often in the form of lesions both sections of the genital organs (vulvovaginitis). The area of the vulva hyperemic, edematous, painful on pressure, covered with a purulent coating. In the grooves and folds of the crust of dried pus. Particularly badly affected inner side of labia majora. Small lips swollen and stick together. Mucosa bleeds easily. Copious purulent discharge. Complaints of itching, burning. During the inspection also often find scratches, eczema or dermatitis of the surrounding skin.
Long. The process involves usually the urethra and rectum.
To differentsirovat need with anemia, scrofula, worms. In the absence of worms eosinophilia can speak for hidden generaly process. The diagnosis is confirmed by finding in the discharge of gonococci.
Sanitary-educational work with women who have gonorrhea, personnel working in institutions; children must have separate cots, private night ware and care items (sponges, washcloths). The staff of children's institutions shall be employed after inspection venereal disease (gynecologist) in the future systematically subjected to the same examination. Children should always be subjected to special examination. Sick and suspicious for the disease gonorrhea children from orphanages are isolated. In institutions the vagina with children produce fluid under running water (use washcloths and sponges is prohibited). To protect the eyes.
In the acute phase of bed rest (hospital). Penicillin 200,000 units at the rate of 30,000 units in 3 hours. Sulfonamides - 0,1 - 0,15 per day per 1 kg of body weight (taking into account the age and General condition of the child) fractional doses 5 times a day every 3 hours for 5 days. With a combination of penicillin and sulfonamides dose of penicillin reduces by half, sulfonamides give within 3 days. When failure of sulfanilamidnami used canovaccio (initial dose 50 - 100 million microbial bodies) or milk (initial dose 0.5 - 1 ml) with subsequent appointment again sulfonamides or penicillin. Local treatment is mandatory (except when conducted penicillin therapy). In the acute stage warm hip baths for 10 to 15 minutes 2 to 3 times a day decoction of chamomile or of a solution of potassium permanganate 1:10 000, after which the external genitals drained (not wiped off) and do my talc. In subacute and chronic stages - washing of the vagina through the thin rubber catheter with a solution of potassium permanganate (1:10 000), followed by instillation of protargol (1 - 2%) or silver nitrate (0.25 to 1%), 3 to 5 ml a day. Simultaneously injected into the urethra to eye dropper 3 to 4 drops of solution of protargol (0,5 - 2%) or silver nitrate (0,25 - 0,5%). If there gonoreynogo lesions of the rectum it is administered 5 to 10 ml of 1 - 3% solution of protargol or its walls smeared with ointment Mikulich.
The criterion of cure. Normal clinical picture and re-enabling the results of laboratory issledovaniya after challenge (gonovakcina - 150 - 200 million microbial bodies, lubrication of the vagina and vulva Lugol's solution, instillation into the urethra and the rectum 2 to 3 drops of 0.5 - 1% solution of silver nitrate; swabs taken from the vagina, urethra and rectum) within 3 months once every month. In the absence of the gonococcus , the child may be admitted to the children's team.