淋病
2.5.1 淋病
同义词
病因和发病机理
病原体：淋病奈瑟菌（1879年A. Neisser首次分离），革兰阴性双球菌；潜伏期为1至6天。感染尿道、宫颈、直肠、结膜的柱状上皮（阴道感染仅限于青春期之前）。
症状
1. 急性：烧灼感，浓稠脓性分泌物
2. 慢性：慢性尿道炎
3. 女性：前庭大腺炎、外阴阴道炎和宫颈炎
4. 生殖器外淋病：直肠、结膜和喉部感染
并发症
逆行感染：
¤ 女性：子宫内膜炎、附件炎（不孕）和腹膜炎
¤ 男性：前列腺炎，附睾炎（不育）
系统性并发症：良性淋病性菌血病（皮炎－关节炎综合征）、肝周炎、心内膜炎和单关节炎。
诊断
依据直接涂片检查淋球菌：细胞内革兰阴性双球菌、免疫荧光检查、培养和PCR（尿液或分泌物）。
鉴别诊断
治疗
1．头孢曲松钠（250mg至500mg），肌肉注射，每天1次同时口服阿奇霉素1g。
2．避免口服头孢菌素和喹诺酮类（细菌耐药）。
3．注意：ａ）苍白密螺旋体混合感染：治疗前和治疗后六个星期进行梅毒血清学检查！ｂ）衣原体混合感染：排除感染或同时治疗（阿奇霉素1g，口服）。 ｃ）艾滋病血清学检查。
4．治疗性伙伴, 追踪涂片检查。
鉴别诊断
Tests
- Find the correct answer. The treatment of choice for non complicated gonorrheal utrehritis is
- Which answer describes the most important differential diagnostic consideration for gonococcal urethritis?
- Which of the following apply to gonorrhea?
- Gonoccocal infection can be present on which of the following mucous membranes?
- Please choose wether the following statements are correct or false.
- Which of the followings apply to gonorrhea?
- Statement 1 Genital gonorrhea can be asymptomatic in up to 50% of cases in women
- Which answer describes the triad typical for disseminated gonococcemia?
- The following mucosal surfaces can be infected by Neisseria gonorrhoeae.
- True or false?
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