What is Gonoblenorrhea in Children?
Gonoblenorrhea in children is also known as gonococcal conjunctivitis. This is an acute form of conjunctivitis caused by nonococci, which affects mainly newborns.
Types of gonoblenorrhea in a child:
- gonococcal conjunctivitis of the newborn
- gonococcal conjunctivitis in children.
Causes of Gonoblenorrhea in Children
The causative agent of the disease is called Neisseria gonorrhoeae.
Neisser gonococcus falls on the conjunctiva of the secret. Further, the infection can spread from the mucous membrane of the infected eye, which will lead to generalization of the infection, in such cases, gonitis, myositis, endocarditis, etc.
The baby can be infected from the mother directly during childbirth. In such cases, symptoms appear 2–3 days after delivery.
Pathogenesis during Gonoblenorrhea in Children
Eyelids sharply and rapidly inflame, swell, become cyanotic-crimson. Edema of the eyelids is dense, this can lead to the fact that the child will not be able to close the eyelids on his own. A characteristic substance is released from the affected eye, similar in texture and shade to meat slops.
Symptoms of Gonoblenorrhea in Children
In newborns, two eyes are usually affected, in older children, 1 eye is affected. First comes the so-called period of infiltration, which manifests itself in severe swelling, hyperemia and densification of the eyelids. It is impossible to turn out the eyelids, only slightly open the palpebral fissure. From the conjunctival cavity, the above described fluid is released.
Conjunctival injection is manifested in edema, friability, bleeding. After 2-4 days, the period of pyorrhea begins, which manifests itself in a decrease in eyelid edema, a decrease in eyelid hardness, and the eyelids become similar in texture to the test.
A foamy creamy purulent purulent discharge is released from the conjunctival cavity in large quantities. For a long time, hyperemia and papillary hypertrophy of the conjunctiva may persist in the period of hyperpapillary infiltration. The inflammatory process can spread to the cornea, which is a common case in children.
Diagnosis of Gonoblenorrhea in Children
Doctors will need not only an external examination to detect clinical manifestations, but also laboratory tests. This is necessary to establish what triggered the disease (gonococcus or other flora).
Treatment of Gonoblenorrhea in Children
For the treatment of gonoblenorrhea in children, antibacterial drugs should be instilled into the conjunctival sac. The most effective are:
- a solution of benzylpenicillin 100 000-333 000 IU / ml (for newborns apply 10 000-20 000 IU / ml)
- cefazolin solution 133 mg / ml, prepared ex temporae
- solution or ointment of ciprofloxacin
- solution of ceftazidime 50 mg / ml, prepared ex temporae
- solution of lomefloxacin 0.3%
- Ofloxacin solution or ointment 0.3%
- erythromycin ointment 1%
- solution of chloramphenicol 0.25%
- Miramistin 0.01% solution
- solution of sulfacyl sodium 10-20%
- a solution of sulfapyridazine sodium 10%.
Tetracycline ointment 1%, fusidic acid solution 1% are also used. Surgical treatment of the urogenital focus of infection or in severe cases of the process involves systemic antibiotic therapy. Use such drugs:
- ceftriaxone intramuscularly in children with a body weight of less than 45 kg of 125 mg once, with a body weight of more than 45 kg according to adult regimens; newborns at 25-50 mg / kg once a day for 2-3 days
- with complicated gonorrhea, cefotaxime intravenously every 8 hours for 1 gram. Continue from 24 to 48 hours after the symptoms are reduced.
First of all, erythromycin inside, azithromycin inside, doxycycline inside are used to treat gonoblenrhea in children. Spectinomycin is administered intramuscularly.
Prevention of Gonoblenorrhea in Children
To prevent gonoblenorrhea in newborns, which become infected during childbirth, reorganization of the mother should be carried out before birth. After birth, the baby is wiped with a cotton swab with a solution of boric acid 2%, then drip a solution of silver nitrate 2% (Matveev-Crede method).
Another way is to place a strip of ointment of 1 cm in each eye once after birth to the baby once: tetracycline 1%, erythromycin 1%.