Гонореја — разлика између измена

С Википедије, слободне енциклопедије
Интерактиван преглед историје
← Старија изменаНовија измена →
Садржај обрисан Садржај додат
ВизуелноВикитекст
.
Ред 1: Ред 1:
{{short description|Полно преносиве инфекције}}
{{Infobox disease
{{rut}}
⚫
| Name = Гонореја
{{Infobox medical condition (new)
| Image = SheMayLookCleanBut.jpg
⚫
| name = Гонореја
| Caption = Poster iz Drugog svetskog rata.
| synonyms = Gonorrhoea, gonococcal infection, gonococcal urethritis, the clap
⚫
| DiseasesDB =
| image = Gonococcal lesion on the skin PHIL 2038 lores.jpg
⚫
| ICD10 = A54
| caption = Gonococcal lesion on the skin
⚫
| ICD9 = {{ICD9|098}}
| pronounce = {{IPAc-en|ˌ|ɡ|ɒ|n|.|ə|ˈ|ɹ|i|.|ə}}
⚫
| ICDO =
| field = [[Infectious disease (medical specialty)|Infectious disease]]
⚫
| OMIM =
| symptoms = None, [[Dysuria|burning with urination]], [[vaginal discharge]], discharge from the [[penis]], [[pelvic pain]], [[testicular pain]]<ref name=CDC2014/>
⚫
| MedlinePlus = 007267
| complications = [[Pelvic inflammatory disease]], [[epididymitis|inflammation of the epididymis]], [[septic arthritis]], [[endocarditis]]<ref name=CDC2014/><ref name=Mor2016/>
⚫
| eMedicineSubj = article
| onset =
⚫
| eMedicineTopic = 782913
| duration =
⚫
| MeshID = D006069
| types =
| causes = ''[[Neisseria gonorrhoeae]]'' typically [[sexually transmitted infection|sexually transmitted]]<ref name=CDC2014/>
| risks =
| diagnosis = Testing the urine, [[urethra]] in males, or [[cervix]] in females<ref name=CDC2014/>
| differential =
| prevention = [[Condom]]s, having sex with only one person who is uninfected, [[sexual abstinence|not having sex]]<ref name=CDC2014/><ref name=STI2015/>
| treatment = [[Ceftriaxone]] by injection and [[azithromycin]] by mouth<ref name=CDC2016Tx/><ref name=Un2015/>
| medication =
| prognosis =
| frequency = 0,8% (жене), 0,6% (мушкарци)<ref name=New2012/>
| deaths =
}}
}}
[[Датотека:SheMayLookCleanBut.jpg|thumb|250px|Постер из Другог светског рата]]
'''Гонореја''', '''трипер''' или '''капавац''' је заразна [[полна болест]] која се преноси полним контактом. Приликом полног контакта долази до преноса бактерије са слузнице полних органа заражене особе на слузницу здраве особе. Бактерије нападају [[цилиндрични епител]] слузнице ([[цервикални канал]], [[ректум]]) изазивајући упалну реакцију.
<!-- Definition and symptom -->
'''Гонореја''', '''трипер''' или '''капавац''' је заразна [[полна болест]] која се преноси полним контактом, caused by the bacterium ''[[Neisseria gonorrhoeae]]''.<ref name=CDC2014/> Приликом полног контакта долази до преноса бактерије са слузнице полних органа заражене особе на слузницу здраве особе. Бактерије нападају [[цилиндрични епител]] слузнице ([[цервикални канал]], [[ректум]]) изазивајући упалну реакцију.<ref>{{cite book|author1=Leslie Delong|author2=Nancy Burkhart|title=General and Oral Pathology for the Dental Hygienist|url=https://books.google.com/books?id=jmhADwAAQBAJ&pg=PT787|date=2017-11-27|publisher=Wolters Kluwer Health|isbn=978-1-4963-5453-2|page=787}}</ref> Infected men may experience [[Dysuria|pain or burning with urination]], discharge from the [[penis]], or [[testicular pain]].<ref name=CDC2014/> Infected women may experience burning with urination, [[vaginal discharge]], vaginal bleeding between [[Menstruation|periods]], or [[pelvic pain]].<ref name=CDC2014/> Complications in women include [[pelvic inflammatory disease]] and in men include [[epididymitis|inflammation of the epididymis]].<ref name=CDC2014/> Many of those infected, however, have no symptoms.<ref name=CDC2014/> If untreated, gonorrhea can spread to [[septic arthritis|joints]] or [[endocarditis|heart valves]].<ref name=CDC2014/><ref name=Mor2016/>


<!-- Cause and diagnosis -->
Ако се ова болест не лечи, изазива [[стерилитет]] код мушкараца и жена и слепило новорођенчади код мајки које су заражене. Болест може захватити и задње црево, слузокожу уста, вежњачу ока и урогенитални тракт. Лечи се антибиотицима, пеницилином, ако је резистентна онда другим. Запуштена болест прелази у хроничну, а из епитела уретре код мушкараца прелази на мокраћну бешику, семеводе, семену кесицу и тестисе као и бубреге.
Gonorrhea is spread through sexual contact with an infected person.<ref name=CDC2014/> This includes oral, anal, and vaginal sex.<ref name=CDC2014/> It can also spread from a [[vertical transmission|mother to a child during birth]].<ref name=CDC2014/> Diagnosis is by testing the urine, [[urethra]] in males, or [[cervix]] in females.<ref name=CDC2014>{{cite web|title=Gonorrhea – CDC Fact Sheet (Detailed Version)|url=https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm|website=CDC|access-date=27 August 2016|date=17 November 2015|url-status=live|archive-url=https://web.archive.org/web/20160902004117/http://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm|archive-date=2 September 2016}}</ref> Testing all women who are sexually active and less than 25 years of age each year as well as those with new sexual partners is recommended;<ref name=STI2015/> the same recommendation applies in [[men who have sex with men]] (MSM).<ref name=STI2015/>

<!-- Treatment -->
Gonorrhea can be prevented with the use of [[condom]]s, having sex with only one person who is uninfected, and by [[sexual abstinence|not having sex]].<ref name=CDC2014/><ref name=STI2015>{{cite journal|last1=Workowski|first1=KA|last2=Bolan|first2=GA|title=Sexually transmitted diseases treatment guidelines, 2015.|journal=MMWR. Recommendations and Reports / Centers for Disease Control|date=5 June 2015|volume=64|issue=RR-03|pages=1–137|pmid=26042815|pmc=5885289}}</ref> Treatment is usually with [[ceftriaxone]] by injection and [[azithromycin]] by mouth.<ref name=CDC2016Tx/><ref name=Un2015/> [[antibiotic resistance|Resistance]] has developed to many previously used [[antibiotic]]s and higher doses of ceftriaxone are occasionally required.<ref name=CDC2016Tx>{{cite web|title=Antibiotic-Resistant Gonorrhea Basic Information|url=https://www.cdc.gov/std/gonorrhea/arg/basic.htm|website=CDC|access-date=27 August 2016|date=13 June 2016|url-status=live|archive-url=https://web.archive.org/web/20160908222601/http://www.cdc.gov/std/gonorrhea/arg/basic.htm|archive-date=8 September 2016}}</ref><ref name=Un2015>{{cite journal|last1=Unemo|first1=M|title=Current and future antimicrobial treatment of gonorrhoea – the rapidly evolving Neisseria gonorrhoeae continues to challenge.|journal=BMC Infectious Diseases|date=21 August 2015|volume=15|pages=364|pmid=26293005|doi=10.1186/s12879-015-1029-2|pmc=4546108}}</ref> Retesting is recommended three months after treatment.<ref name=STI2015/> Sexual partners from the last two months should also be treated.<ref name=CDC2014/>

<!-- Epidemiology and history -->
Gonorrhea affects about 0.8% of women and 0.6% of men.<ref name=New2012>{{cite journal|last1=Newman|first1=Lori|last2=Rowley|first2=Jane|last3=Vander Hoorn|first3=Stephen|last4=Wijesooriya|first4=Nalinka Saman|last5=Unemo|first5=Magnus|last6=Low|first6=Nicola|last7=Stevens|first7=Gretchen|last8=Gottlieb|first8=Sami|last9=Kiarie|first9=James|last10=Temmerman|first10=Marleen|last11=Meng|first11=Zhefeng|title=Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting|journal=PLOS ONE|date=8 December 2015|volume=10|issue=12|pages=e0143304|doi=10.1371/journal.pone.0143304|pmid=26646541|pmc=4672879|bibcode=2015PLoSO..1043304N}}</ref> An estimated 33 to 106 million new cases occur each year, out of the 498 million new cases of curable STI – which also includes [[syphilis]], [[chlamydia]], and [[trichomoniasis]].<ref>{{cite journal|last1=Global Burden of Disease Study 2013|first1=Collaborators|title=Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013.|journal=Lancet|date=22 August 2015|volume=386|issue=9995|pages=743–800|pmid=26063472|doi=10.1016/s0140-6736(15)60692-4|pmc=4561509}}</ref><ref name=WHOEpi14>{{cite report|title=Emergence of multi-drug resistant Neisseria gonorrhoeae|publisher=World Health Organisation|date=2012|url=http://apps.who.int/iris/bitstream/10665/70603/1/WHO_RHR_11.14_eng.pdf|archive-url=https://www.webcitation.org/6SWdmr9aY?url=http://whqlibdoc.who.int/hq/2011/WHO_RHR_11.14_eng.pdf|archive-date=12 September 2014|pages=2|url-status=dead}}</ref> Infections in women most commonly occur when they are young adults.<ref name=STI2015/> In 2015, it caused about 700 deaths.<ref name=GBD2015De>{{cite journal|last1=GBD 2015 Mortality and Causes of Death|first1=Collaborators.|title=Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015.|journal=Lancet|date=8 October 2016|volume=388|issue=10053|pages=1459–1544|pmid=27733281|doi=10.1016/s0140-6736(16)31012-1|pmc=5388903}}</ref> Descriptions of the disease date back to before the [[Common Era]] within the [[Old Testament]].<ref name=Mor2016/> The current name was first used by the Greek physician [[Galen]] before 200 CE who referred to it as "an unwanted discharge of semen".<ref name=Mor2016>{{cite journal|last1=Morgan|first1=MK|last2=Decker|first2=CF|title=Gonorrhea.|journal=Disease-a-month : DM|date=August 2016|volume=62|issue=8|pages=260–8|pmid=27107780|doi=10.1016/j.disamonth.2016.03.009}}</ref>


== Симптоми ==
== Симптоми ==
Често је гонореја асимптоматска, па заражени не примећују никакве проблеме. Ако постоје, најчешћи су симптоми исцедак из [[вагина|вагине]] и болна упала слузнице порођајног канала.


Мушкарци понекад могу приметити жути, слузави исцедак из [[пенис]]а, [[крв]] у [[мокраћа|урину]] или боцкање при мокрењу. Од 1 до 10 дана после [[инфекција|инфекције]] јавља се запаљење и болови у уретри (мокраћном каналу пениса). Ако се не лечи секрет постаје бистар и лепљив и одржава се неколико месеци док се не јави грозница и оток лимфних жлезда у препонама. Ако се не лечи, гонореја може изазвати неплодност, нешто ређе сепсу или оштећења других органа ([[срце|срца]] и [[мозак|мозга]]).
Често је гонореја асимптоматска, па заражени не примећују никакве проблеме. Ако постоје, најчешћи су симптоми исцедак из [[вагина|вагине]] и болна упала слузнице порођајног канала.<ref name=":0" /> Мушкарци понекад могу приметити жути, слузави исцедак из [[пенис]]а, [[крв]] у [[мокраћа|урину]] или боцкање при мокрењу. Од 1 до 10 дана после [[инфекција|инфекције]] јавља се запаљење и болови у уретри (мокраћном каналу пениса).<ref name=Zakher>{{cite journal|last1=Zakher|first1=Bernadette|last2=Cantor MD|first2=Amy G.|last3=Daeges |first3=Monica| last4=Nelson MD |first4=Heidi|title=Review: Screening for Gonorrhea and Chlamydia: A Systematic Review for the U.S. Prevententive Services Task Force|journal=Annals of Internal Medicine|pages=884–894 |date=16 December 2014|volume=161|issue=12|doi=10.7326/M14-1022|pmid=25244000|citeseerx=10.1.1.691.6232|s2cid=207538182}}</ref><ref name=marr>{{Cite book|title=Sexually Transmitted Diseases: A Physician Tells You What You Need to Know|last=Marr|first=Lisa|edition=Second|year=2007|orig-year=1998|publisher=Johns Hopkins University|place=Baltimore, Maryland|url=https://books.google.com/books?id=aywGiP9w-u8C&q=gonorrhea+throat&pg=PT150|isbn=978-0-8018-8658-4}}</ref> Ако се не лечи секрет постаје бистар и лепљив и одржава се неколико месеци док се не јави грозница и оток лимфних жлезда у препонама. Ако се не лечи, гонореја може изазвати неплодност, нешто ређе сепсу или оштећења других органа ([[срце|срца]] и [[мозак|мозга]]).<ref name=":0">{{Cite web|url=https://www.mayoclinic.org/diseases-conditions/gonorrhea/symptoms-causes/syc-20351774|title=Gonorrhea - Symptoms and causes|website=Mayo Clinic|language=en|access-date=2019-08-06}}</ref> Код жена симптоми се не морају испољити, а код неких се јавља бол у доњем делу трбуха. Заражене жене могу болест пренети на [[фетус]]. Код мушкараца се нелечена гонореја може проширити на простату, семенике и пасеменике, те такође утицати на плодност.


===Women===
Код жена симптоми се не морају испољити, а код неких се јавља бол у доњем делу трбуха. Заражене жене могу болест пренети на [[фетус]]. Код мушкараца се нелечена гонореја може проширити на простату, семенике и пасеменике, те такође утицати на плодност.
Half of women with gonorrhea are [[asymptomatic]] but the other half experience [[vaginal discharge]], lower abdominal pain, or [[dyspareunia|pain with sexual intercourse]] associated with [[Cervicitis|inflammation of the uterine cervix]].<ref name="Smith2015">{{cite journal|last1=Smith|first1=L|last2=Angarone|first2=MP|title=Sexually Transmitted Infections|journal=The Urologic Clinics of North America|date=November 2015|volume=42|issue=4|pages=507–18|doi=10.1016/j.ucl.2015.06.004|pmid=26475947|citeseerx=10.1.1.590.3827}}</ref><ref name=CE07/><ref name=Sternak2014/> Common medical complications of untreated gonorrhea in women include [[pelvic inflammatory disease]] which can cause scars to the [[fallopian tubes]] and result in later [[ectopic pregnancy]] among those women who become pregnant.<ref name=webmd/>

===Men===
Most infected men with symptoms have [[urethritis|inflammation of the penile urethra]] associated with a [[dysuria|burning sensation during urination]] and discharge from the penis.<ref name=CE07/> In men, discharge with or without burning occurs in half of all cases and is the most common symptom of the infection.<ref name="Shmaefsky2009p52">{{cite book|author=Brian R. Shmaefsky|title=Gonorrhea|url=https://books.google.com/books?id=3iS7tXxC_HQC&pg=PA49|date=1 January 2009|publisher=Infobase|isbn=978-1-4381-0142-2|page=52}}</ref> This pain is caused by a narrowing and stiffening of the urethral [[Lumen (anatomy)|lumen]].<ref name="ChengBostwick2014">{{cite book|author1=Liang Cheng|author2=David G. Bostwick|title=Urologic Surgical Pathology E-Book|url=https://books.google.com/books?id=wrHQAgAAQBAJ&pg=PA863|date=24 January 2014|publisher=Elsevier Health Sciences|isbn=978-0-323-08619-6|page=863}}</ref> The most common medical complication of gonorrhea in men is [[epididymitis|inflammation of the epididymis]].<ref name=webmd>{{cite web|title=What Complications Can Gonorrhea Cause?|work=WebMD|url=https://www.webmd.com/sexual-conditions/complications-gonorrhea-cause|date=2019}}</ref> Gonorrhea is also associated with increased risk of [[prostate cancer]].<ref name="CainiGandini2014">{{cite journal|last1=Caini|first1=Saverio|last2=Gandini|first2=Sara|last3=Dudas|first3=Maria|last4=Bremer|first4=Viviane|last5=Severi|first5=Ettore|last6=Gherasim|first6=Alin|title=Sexually transmitted infections and prostate cancer risk: A systematic review and meta-analysis|journal=Cancer Epidemiology|volume=38|issue=4|year=2014|pages=329–338|pmid= 24986642|doi=10.1016/j.canep.2014.06.002}}</ref>

===Infants===
[[File:Gonococcal ophthalmia neonatorum.jpg|thumb|left|An infant with gonorrhea of the eyes]]
If not treated, [[neonatal conjunctivitis|gonococcal ophthalmia neonatorum]] will develop in 28% of infants born to women with gonorrhea.<ref>{{cite web|url=http://www.phac-aspc.gc.ca/publicat/clinic-clinique/pdf/s1c16e.pdf|title=Prophylaxis for Gonococcal and Chlamydial Ophthalmia Neonatorum ''in'' the Canadian Guide to Clinical Preventative Health Care|publisher=Public Health Agency of Canada|url-status=dead|archive-url=https://web.archive.org/web/20100310075359/http://www.phac-aspc.gc.ca//publicat/clinic-clinique/pdf/s1c16e.pdf|archive-date=10 March 2010}}</ref>

===Spread===
If left untreated, gonorrhea can spread from the original site of infection and infect and damage the joints, skin, and other organs. Indications of this can include fever, skin rashes, sores, and joint pain and swelling.<ref name=webmd/> In advanced cases, gonorrhea may cause a general [[Fatigue (medical)|feeling of tiredness]] similar to other infections.<ref name="Shmaefsky2009p52"/> It is also possible for an individual to have an [[allergy|allergic reaction]] to the bacteria, in which case any appearing symptoms will be greatly intensified.<ref name="Shmaefsky2009p52"/> Very rarely it may settle in the heart, causing [[endocarditis]], or in the spinal column, causing [[meningitis]]. Both are more likely among individuals with suppressed immune systems, however.<ref name=marr/>

== Узроци ==
[[File:Neisseria gonorrhoeae micrograph.jpg|thumb|Multiple views of a ''[[Neisseria gonorrhoeae]]'' bacterium, which causes gonorrhea]]
Gonorrhea is caused by the bacterium ''[[Neisseria gonorrhoeae]]''.<ref name=CE07/> Previous infection does not confer immunity – a person who has been infected can become infected again by exposure to someone who is infected. Infected persons may be able to infect others repeatedly without having any signs or symptoms of their own.

===Spread===
The infection is usually spread from one person to another through [[Sexual intercourse|vaginal]], [[Oral sex|oral]], or [[anal sex]].<ref name=CE07/><ref name="TrebachChaulk2015">{{cite journal|last1=Trebach|first1=Joshua D.|last2=Chaulk|first2=C. Patrick|last3=Page|first3=Kathleen R.|last4=Tuddenham|first4=Susan|last5=Ghanem|first5=Khalil G.|title=Neisseria gonorrhoeae and Chlamydia trachomatis Among Women Reporting Extragenital Exposures|journal=Sexually Transmitted Diseases|volume=42|issue=5|year=2015|pages=233–239|issn=0148-5717|doi=10.1097/OLQ.0000000000000248|pmid=25868133|pmc=4672628}}</ref> Men have a 20% risk of getting the infection from a single act of vaginal intercourse with an infected woman. The risk for men that have sex with men (MSM) is higher.<ref name="Howard Brown">Howard Brown Health Center: STI Annual Report, 2009</ref> Active MSM may get a penile infection, while passive MSM may get anorectal gonorrhea.<ref name="Gollmann-Hempel">{{cite book|first=Wilhelm|last=Gollmann|title=Homeopathic Guide to all Diseases Urinary and Sexual Organ|publisher=Rademacher & Sheek|others=[[Charles Julius Hempel]]|year=1854|url=https://books.google.com/books?id=AzkzAQAAMAAJ&q=%22unnatural+gratification+of+the+sexual+instinct%22&pg=PA79}}</ref> Women have a 60–80% risk of getting the infection from a single act of vaginal intercourse with an infected man.<ref name="condomreport">National Institute of Allergy and Infectious Diseases; National Institutes of Health, Department of Health and Human Services (20 July 2001). "Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention". Hyatt Dulles Airport, Herndon, Virginia. pp14</ref>

A mother may transmit gonorrhea to her newborn during childbirth; when affecting the infant's eyes, it is referred to as [[ophthalmia neonatorum]].<ref name=CE07/> It may be able to spread through the objects contaminated with body fluid from an infected person.<ref name="Good2007">{{cite journal|last1=Goodyear-Smith|first1=F|title=What is the evidence for non-sexual transmission of gonorrhoea in children after the neonatal period? A systematic review.|journal=Journal of Forensic and Legal Medicine|date=November 2007|volume=14|issue=8|pages=489–502|pmid=17961874|doi=10.1016/j.jflm.2007.04.001}}</ref> The bacteria typically does not survive long outside the body, typically dying within minutes to hours.<ref name="Shmaefsky2009p48">{{cite book|author=Brian R. Shmaefsky|title=Gonorrhea|url=https://books.google.com/books?id=3iS7tXxC_HQC&pg=PA48|date=1 January 2009|publisher=Infobase|isbn=978-1-4381-0142-2|page=48}}</ref>


== Лечење ==
== Лечење ==
Лечење се обавља [[антибиотик|антибиотицима]], од којих се мора применити неколико врста. У последњих десет година све је више врста -{Neisseria gonorrhoeae}- отпорних на антибиотике, па лечење постаје теже.
Лечење се обавља [[антибиотик|антибиотицима]], од којих се мора применити неколико врста. У последњих десет година све је више врста -{Neisseria gonorrhoeae}- отпорних на антибиотике, па лечење постаје теже.


== Референце ==
⚫
{{Commonscat|Gonorrhea}}
{{Reflist|refs=
<ref name=CE07>{{cite journal |author=Moran JS |title=Gonorrhoea |journal=Clin Evid (Online) |volume=2007 |year=2007 |pmid=19454057 |pmc=2943790}}</ref>
<ref name=Sternak2014>{{cite journal|last1=Ljubin-Sternak|first1=Suncanica|last2=Mestrovic|first2=Tomislav|title=Review: Chlamydia trachonmatis and Genital Mycoplasmias: Pathogens with an Impact on Human Reproductive Health|journal=Journal of Pathogens|page=7 |date=2014|volume=2014|issue=183167|doi=10.1155/2014/183167|pmid=25614838|pmc=4295611}}</ref>
}}

== Спољашње везе ==
⚫
{{Commons category|Gonorrhea}}
* {{curlie|Health/Reproductive_Health/Sexually_Transmitted_Diseases/Gonorrhea/}}
* -{[https://www.cdc.gov/std/Gonorrhea/STDFact-gonorrhea.htm "Gonorrhea – CDC Fact Sheet"]}-
{{Medical resources
⚫
| DiseasesDB=8834
⚫
| ICD10 = A54
⚫
| ICD9 = {{ICD9|098}}
⚫
| ICDO =
⚫
| OMIM =
⚫
| MedlinePlus = 007267
⚫
| eMedicineSubj = article
⚫
| eMedicineTopic = 782913
⚫
| MeshID = D006069
}}

{{Authority control}}
⚫
{{Порталбар|Медицина}}
{{медицинско упозорење}}
{{медицинско упозорење}}
⚫
{{Порталбар|Медицина}}


[[Категорија:Полно преносиве болести]]
[[Категорија:Полно преносиве болести]]

Верзија на датум 31. децембар 2020. у 21:58

Гонореја
СинонимиGonorrhoea, gonococcal infection, gonococcal urethritis, the clap
Gonococcal lesion on the skin
Изговор
СпецијалностиInfectious disease
СимптомиNone, burning with urination, vaginal discharge, discharge from the penis, pelvic pain, testicular pain[1]
КомпликацијеPelvic inflammatory disease, inflammation of the epididymis, septic arthritis, endocarditis[1][2]
УзроциNeisseria gonorrhoeae typically sexually transmitted[1]
Дијагностички методTesting the urine, urethra in males, or cervix in females[1]
ПревенцијаCondoms, having sex with only one person who is uninfected, not having sex[1][3]
ЛечењеCeftriaxone by injection and azithromycin by mouth[4][5]
Фреквенција0,8% (жене), 0,6% (мушкарци)[6]
Постер из Другог светског рата

Гонореја, трипер или капавац је заразна полна болест која се преноси полним контактом, caused by the bacterium Neisseria gonorrhoeae.[1] Приликом полног контакта долази до преноса бактерије са слузнице полних органа заражене особе на слузницу здраве особе. Бактерије нападају цилиндрични епител слузнице (цервикални канал, ректум) изазивајући упалну реакцију.[7] Infected men may experience pain or burning with urination, discharge from the penis, or testicular pain.[1] Infected women may experience burning with urination, vaginal discharge, vaginal bleeding between periods, or pelvic pain.[1] Complications in women include pelvic inflammatory disease and in men include inflammation of the epididymis.[1] Many of those infected, however, have no symptoms.[1] If untreated, gonorrhea can spread to joints or heart valves.[1][2]

Gonorrhea is spread through sexual contact with an infected person.[1] This includes oral, anal, and vaginal sex.[1] It can also spread from a mother to a child during birth.[1] Diagnosis is by testing the urine, urethra in males, or cervix in females.[1] Testing all women who are sexually active and less than 25 years of age each year as well as those with new sexual partners is recommended;[3] the same recommendation applies in men who have sex with men (MSM).[3]

Gonorrhea can be prevented with the use of condoms, having sex with only one person who is uninfected, and by not having sex.[1][3] Treatment is usually with ceftriaxone by injection and azithromycin by mouth.[4][5] Resistance has developed to many previously used antibiotics and higher doses of ceftriaxone are occasionally required.[4][5] Retesting is recommended three months after treatment.[3] Sexual partners from the last two months should also be treated.[1]

Gonorrhea affects about 0.8% of women and 0.6% of men.[6] An estimated 33 to 106 million new cases occur each year, out of the 498 million new cases of curable STI – which also includes syphilis, chlamydia, and trichomoniasis.[8][9] Infections in women most commonly occur when they are young adults.[3] In 2015, it caused about 700 deaths.[10] Descriptions of the disease date back to before the Common Era within the Old Testament.[2] The current name was first used by the Greek physician Galen before 200 CE who referred to it as "an unwanted discharge of semen".[2]

Симптоми

Често је гонореја асимптоматска, па заражени не примећују никакве проблеме. Ако постоје, најчешћи су симптоми исцедак из вагине и болна упала слузнице порођајног канала.[11] Мушкарци понекад могу приметити жути, слузави исцедак из пениса, крв у урину или боцкање при мокрењу. Од 1 до 10 дана после инфекције јавља се запаљење и болови у уретри (мокраћном каналу пениса).[12][13] Ако се не лечи секрет постаје бистар и лепљив и одржава се неколико месеци док се не јави грозница и оток лимфних жлезда у препонама. Ако се не лечи, гонореја може изазвати неплодност, нешто ређе сепсу или оштећења других органа (срца и мозга).[11] Код жена симптоми се не морају испољити, а код неких се јавља бол у доњем делу трбуха. Заражене жене могу болест пренети на фетус. Код мушкараца се нелечена гонореја може проширити на простату, семенике и пасеменике, те такође утицати на плодност.

Women

Half of women with gonorrhea are asymptomatic but the other half experience vaginal discharge, lower abdominal pain, or pain with sexual intercourse associated with inflammation of the uterine cervix.[14][15][16] Common medical complications of untreated gonorrhea in women include pelvic inflammatory disease which can cause scars to the fallopian tubes and result in later ectopic pregnancy among those women who become pregnant.[17]

Men

Most infected men with symptoms have inflammation of the penile urethra associated with a burning sensation during urination and discharge from the penis.[15] In men, discharge with or without burning occurs in half of all cases and is the most common symptom of the infection.[18] This pain is caused by a narrowing and stiffening of the urethral lumen.[19] The most common medical complication of gonorrhea in men is inflammation of the epididymis.[17] Gonorrhea is also associated with increased risk of prostate cancer.[20]

Infants

An infant with gonorrhea of the eyes

If not treated, gonococcal ophthalmia neonatorum will develop in 28% of infants born to women with gonorrhea.[21]

Spread

If left untreated, gonorrhea can spread from the original site of infection and infect and damage the joints, skin, and other organs. Indications of this can include fever, skin rashes, sores, and joint pain and swelling.[17] In advanced cases, gonorrhea may cause a general feeling of tiredness similar to other infections.[18] It is also possible for an individual to have an allergic reaction to the bacteria, in which case any appearing symptoms will be greatly intensified.[18] Very rarely it may settle in the heart, causing endocarditis, or in the spinal column, causing meningitis. Both are more likely among individuals with suppressed immune systems, however.[13]

Узроци

Multiple views of a Neisseria gonorrhoeae bacterium, which causes gonorrhea

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae.[15] Previous infection does not confer immunity – a person who has been infected can become infected again by exposure to someone who is infected. Infected persons may be able to infect others repeatedly without having any signs or symptoms of their own.

Spread

The infection is usually spread from one person to another through vaginal, oral, or anal sex.[15][22] Men have a 20% risk of getting the infection from a single act of vaginal intercourse with an infected woman. The risk for men that have sex with men (MSM) is higher.[23] Active MSM may get a penile infection, while passive MSM may get anorectal gonorrhea.[24] Women have a 60–80% risk of getting the infection from a single act of vaginal intercourse with an infected man.[25]

A mother may transmit gonorrhea to her newborn during childbirth; when affecting the infant's eyes, it is referred to as ophthalmia neonatorum.[15] It may be able to spread through the objects contaminated with body fluid from an infected person.[26] The bacteria typically does not survive long outside the body, typically dying within minutes to hours.[27]

Лечење

Лечење се обавља антибиотицима, од којих се мора применити неколико врста. У последњих десет година све је више врста Neisseria gonorrhoeae отпорних на антибиотике, па лечење постаје теже.

Референце

  1. ^ а б в г д ђ е ж з и ј к л љ м н њ „Gonorrhea – CDC Fact Sheet (Detailed Version)”. CDC. 17. 11. 2015. Архивирано из оригинала 2. 9. 2016. г. Приступљено 27. 8. 2016. 
  2. ^ а б в г Morgan, MK; Decker, CF (август 2016). „Gonorrhea.”. Disease-a-month : DM. 62 (8): 260—8. PMID 27107780. doi:10.1016/j.disamonth.2016.03.009. 
  3. ^ а б в г д ђ Workowski, KA; Bolan, GA (5. 6. 2015). „Sexually transmitted diseases treatment guidelines, 2015.”. MMWR. Recommendations and Reports / Centers for Disease Control. 64 (RR-03): 1—137. PMC 5885289 Слободан приступ. PMID 26042815. 
  4. ^ а б в „Antibiotic-Resistant Gonorrhea Basic Information”. CDC. 13. 6. 2016. Архивирано из оригинала 8. 9. 2016. г. Приступљено 27. 8. 2016. 
  5. ^ а б в Unemo, M (21. 8. 2015). „Current and future antimicrobial treatment of gonorrhoea – the rapidly evolving Neisseria gonorrhoeae continues to challenge.”. BMC Infectious Diseases. 15: 364. PMC 4546108 Слободан приступ. PMID 26293005. doi:10.1186/s12879-015-1029-2. 
  6. ^ а б Newman, Lori; Rowley, Jane; Vander Hoorn, Stephen; Wijesooriya, Nalinka Saman; Unemo, Magnus; Low, Nicola; Stevens, Gretchen; Gottlieb, Sami; Kiarie, James; Temmerman, Marleen; Meng, Zhefeng (8. 12. 2015). „Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting”. PLOS ONE. 10 (12): e0143304. Bibcode:2015PLoSO..1043304N. PMC 4672879 Слободан приступ. PMID 26646541. doi:10.1371/journal.pone.0143304. 
  7. ^ Leslie Delong; Nancy Burkhart (2017-11-27). General and Oral Pathology for the Dental Hygienist. Wolters Kluwer Health. стр. 787. ISBN 978-1-4963-5453-2. 
  8. ^ Global Burden of Disease Study 2013, Collaborators (22. 8. 2015). „Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013.”. Lancet. 386 (9995): 743—800. PMC 4561509 Слободан приступ. PMID 26063472. doi:10.1016/s0140-6736(15)60692-4. 
  9. ^ Emergence of multi-drug resistant Neisseria gonorrhoeae (PDF) (Извештај). World Health Organisation. 2012. стр. 2. Архивирано из оригинала (PDF) 12. 9. 2014. г. 
  10. ^ GBD 2015 Mortality and Causes of Death, Collaborators. (8. 10. 2016). „Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015.”. Lancet. 388 (10053): 1459—1544. PMC 5388903 Слободан приступ. PMID 27733281. doi:10.1016/s0140-6736(16)31012-1. 
  11. ^ а б „Gonorrhea - Symptoms and causes”. Mayo Clinic (на језику: енглески). Приступљено 2019-08-06. 
  12. ^ Zakher, Bernadette; Cantor MD, Amy G.; Daeges, Monica; Nelson MD, Heidi (16. 12. 2014). „Review: Screening for Gonorrhea and Chlamydia: A Systematic Review for the U.S. Prevententive Services Task Force”. Annals of Internal Medicine. 161 (12): 884—894. CiteSeerX 10.1.1.691.6232 Слободан приступ. PMID 25244000. S2CID 207538182. doi:10.7326/M14-1022. 
  13. ^ а б Marr, Lisa (2007) [1998]. Sexually Transmitted Diseases: A Physician Tells You What You Need to Know (Second изд.). Baltimore, Maryland: Johns Hopkins University. ISBN 978-0-8018-8658-4. 
  14. ^ Smith, L; Angarone, MP (новембар 2015). „Sexually Transmitted Infections”. The Urologic Clinics of North America. 42 (4): 507—18. CiteSeerX 10.1.1.590.3827 Слободан приступ. PMID 26475947. doi:10.1016/j.ucl.2015.06.004. 
  15. ^ а б в г д Moran JS (2007). „Gonorrhoea”. Clin Evid (Online). 2007. PMC 2943790 Слободан приступ. PMID 19454057. 
  16. ^ Ljubin-Sternak, Suncanica; Mestrovic, Tomislav (2014). „Review: Chlamydia trachonmatis and Genital Mycoplasmias: Pathogens with an Impact on Human Reproductive Health”. Journal of Pathogens. 2014 (183167): 7. PMC 4295611 Слободан приступ. PMID 25614838. doi:10.1155/2014/183167. 
  17. ^ а б в „What Complications Can Gonorrhea Cause?”. WebMD. 2019. 
  18. ^ а б в Brian R. Shmaefsky (1. 1. 2009). Gonorrhea. Infobase. стр. 52. ISBN 978-1-4381-0142-2. 
  19. ^ Liang Cheng; David G. Bostwick (24. 1. 2014). Urologic Surgical Pathology E-Book. Elsevier Health Sciences. стр. 863. ISBN 978-0-323-08619-6. 
  20. ^ Caini, Saverio; Gandini, Sara; Dudas, Maria; Bremer, Viviane; Severi, Ettore; Gherasim, Alin (2014). „Sexually transmitted infections and prostate cancer risk: A systematic review and meta-analysis”. Cancer Epidemiology. 38 (4): 329—338. PMID 24986642. doi:10.1016/j.canep.2014.06.002. 
  21. ^ „Prophylaxis for Gonococcal and Chlamydial Ophthalmia Neonatorum in the Canadian Guide to Clinical Preventative Health Care” (PDF). Public Health Agency of Canada. Архивирано из оригинала (PDF) 10. 3. 2010. г. 
  22. ^ Trebach, Joshua D.; Chaulk, C. Patrick; Page, Kathleen R.; Tuddenham, Susan; Ghanem, Khalil G. (2015). „Neisseria gonorrhoeae and Chlamydia trachomatis Among Women Reporting Extragenital Exposures”. Sexually Transmitted Diseases. 42 (5): 233—239. ISSN 0148-5717. PMC 4672628 Слободан приступ. PMID 25868133. doi:10.1097/OLQ.0000000000000248. 
  23. ^ Howard Brown Health Center: STI Annual Report, 2009
  24. ^ Gollmann, Wilhelm (1854). Homeopathic Guide to all Diseases Urinary and Sexual Organ. Charles Julius Hempel. Rademacher & Sheek. 
  25. ^ National Institute of Allergy and Infectious Diseases; National Institutes of Health, Department of Health and Human Services (20 July 2001). "Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention". Hyatt Dulles Airport, Herndon, Virginia. pp14
  26. ^ Goodyear-Smith, F (новембар 2007). „What is the evidence for non-sexual transmission of gonorrhoea in children after the neonatal period? A systematic review.”. Journal of Forensic and Legal Medicine. 14 (8): 489—502. PMID 17961874. doi:10.1016/j.jflm.2007.04.001. 
  27. ^ Brian R. Shmaefsky (1. 1. 2009). Gonorrhea. Infobase. стр. 48. ISBN 978-1-4381-0142-2. 

Спољашње везе

Гонореја на Викимедијиној остави.
Класификација
Спољашњи ресурси
Молимо Вас, обратите пажњу на важно упозорење
у вези са темама из области медицине (здравља).
Преузето из „https://sr.wikipedia.org/w/index.php?title=Гонореја&oldid=23519414”