Gonorrhea in children: symptoms, diagnosis, treatment. Gonorrhea in children and adolescents - symptoms and treatment Is gonorrhea prevention carried out for newborn girls?

Gonorrhea in a child can be transmitted in various ways. In infants, infection occurs during the birth process or inside the mother's womb. Older children and adolescents become infected through household and sexual contact. Basically, girls are more often infected with gonorrhea, due to the peculiarities of the anatomical structure of the genital organs. Gonococcus enters their body through common objects, for example, washcloths, bathtubs, toilets. The household route of infection in boys is almost impossible. They usually become infected during adolescence, through unprotected sexual contact with a patient with this infection.

Household infection occurs mainly in preschool institutions due to violated sanitary standards when processing objects with which children have direct contact. A child can also become infected at home from infected parents who do not follow hygiene rules.

Overall, gonorrhea is 15 times more common in girls. The infection occurs immediately, although its symptoms begin to manifest themselves after a certain period of time. The incubation period of the disease lasts from 2-3 days to 2-3 weeks.

Symptoms

Gonorrhea occurs with pronounced symptoms, especially in girls. Most often in girls it manifests itself in the form of the following signs:

• purulent discharge from the vagina;
• swelling of the genitals and itching sensation in them;
• general malaise;
• elevated temperature;
• pain when urinating and pain in the lower abdomen.

Signs of gonorrhea in boys are as pronounced as in girls. Symptoms of the disease include:

• inflammation in the urethra;
• redness of the glans and foreskin;
• the appearance of purulent discharge from the urethra.

If a child has chronic gonorrhea, the testicles, prostate, and seminal vesicles may be involved.

The disease is classified into several main types. Classification of pathology is carried out depending on the duration of its course. Pathology is divided into two types:

• Fresh gonorrhea, in which the child has been sick for less than two months.
• Chronic gonorrhea, in which children are ill for more than two months.

Also, the infection is classified into several types, depending on the severity of the course. It is acute, characterized by the rapid development of symptoms, subacute, expressed in the gradual development of symptoms, and torpid, in which the symptoms of the disease are almost invisible. Moreover, gonorrhea can be latent, that is, it occurs without symptoms.

Diagnosis of gonorrhea in a child

Diagnosis of gonorrhea is carried out on the basis of a study of the symptoms and anamnesis of pathology in a child. A general examination of children by a urologist or gynecologist is also carried out. After that, PCR diagnostics is prescribed, which allows to detect the presence of gonococcus in secretions from the genital organs. A microscopic examination of a smear from the vagina or urethra and bacteriological culture is also carried out to determine the sensitivity of gonococci to antibiotics. If a teenager is already sexually active, he should definitely be shown to a gynecologist or urologist.

Complications

If a child has had gonorrhea in childhood, this can lead to infertility in the future. Thus, it is important to notice the signs of the disease in time and immediately consult a doctor for treatment. Independent actions can lead to disastrous results.

Treatment

What can you do

If symptoms of gonorrhea are detected in a child, you should not self-medicate under any circumstances. The child should be shown to a doctor for examination and diagnosis. Moreover, only a doctor, based on the data obtained, will be able to prescribe competent treatment. The task of parents is to listen to all the doctor’s recommendations and follow them exactly.

What does a doctor do

Gonorrhea in a child is usually treated comprehensively and at home. The doctor prescribes a course of antibiotics to fight the infection. In addition, girls are given irrigation of their genitals with special antiseptic solutions. The child may also be prescribed physiotherapeutic treatment and take special medications - probiotics, the action of which is aimed at restoring the vaginal microflora.

After the treatment is over, the child should be observed by a doctor for three months. After completion of therapy, two weeks later, a control diagnosis of the child's body for the presence of gonococcus is carried out.

Prevention

Prevention of gonorrhea in a child includes the obligatory observance of the rules of personal hygiene. Parents should categorically forbid children to use other people's body wash sponges, towels, underwear, and also sit on the toilet in a public place or use a shared bathroom.

For teenagers who are already sexually active, it is important to consider the following points:

• gonorrhea occurs due to casual sex, so it is necessary to exclude them;
• barrier contraception helps prevent the disease;
• observing the rules of personal hygiene is important and necessary.

Adolescents should be regularly screened for infections that are sexually transmitted. Girls should visit a gynecologist at least 2 times a year, and boys should visit a urologist at least once a year. If alarming symptoms appear, you should immediately consult a doctor. Compliance with preventive measures will help prevent the possibility of the occurrence of the disease.

Infection and course
Gonorrhea in early childhood mainly affects girls. Infection occurs mainly through transmission from adults.

Infection of young children, especially girls, occurs if they sleep in the same bed with mothers or nannies infected with gonorrhea, as well as through sponges, contaminated hands, etc.

Gonococcus, as mentioned above, is able to penetrate through the intact epithelium of the mucous membranes, and the most favorable soil for its development is the single-layer columnar epithelium of the mucous membranes and the excretory ducts of the glands. Both the skin and the mucous membrane, covered with stratified squamous epithelium, are impermeable to gonococcus; therefore, when it gets on the mucous membrane of a multiparous woman, gonococcus does not usually cause inflammatory phenomena. Meanwhile, the delicate squamous epithelium of the vulva in children and young girls is, on the contrary, a favorable environment for the introduction of gonococcus.

When gonococcus gets on the genitals of a girl, the disease most often manifests itself in the form of vulvovaginitis, i.e., an inflammatory process in the area of ​​the vulva, vestibule and vagina. When examining the external genitalia, redness and swelling of the tissues and purulent discharge from the vagina are detected. Sometimes, when a sick child is poorly cared for, the vulva becomes covered with dried purulent secretion in the form of crusts.

Due to the tenderness of the skin, the inflammatory reaction often spreads to the thighs and groin folds. Usually, inflammation of the urethra quickly develops due to its proximity to the site of infection.

It is not uncommon for inflammation of the Bartholin glands to occur. Purulent discharge flowing down can lead to infection of the rectal mucosa. Enlargement and tenderness of the inguinal lymph nodes are often observed.

Symptoms of vulvovaginitis are not always clear. In early childhood, the disease manifests itself in the child's crying (especially when urinating), loss of appetite and sleep. The temperature is usually low-grade. The diagnosis is made based on the presence of gonococcus in the discharge.

Usually the process is limited to the lower part of the reproductive apparatus; the ascending part develops relatively rarely.

Treatment
A sick child should be isolated from other children. It is advisable to carry out treatment in a hospital. In the subacute and chronic stages, treatment can be carried out on an outpatient basis. Penicillin and sulfonamide therapy is indicated in all stages of the disease. Penicillin is used in the same doses as in adults.

Sulfanilamide drugs (sulfidine, sulfazole, norsulfazole, sulfadiazine) are prescribed depending on the age and general condition of the child. Immunotherapy is not recommended for children under 3 years of age. Local treatment is started when there is no cure after treatment with penicillin.

The criterion for cure is a normal clinical picture and negative results of repeated laboratory tests of smears for gonococci after provocation. A child can be admitted to the children's group only after he is declared recovered.

Treatment of childhood gonorrhea can only be carried out by a doctor, since inept and incorrect treatment leads to serious, sometimes irreparable consequences.

Prevention

Prevention of infection of children with gonorrhea should be carried out through various measures.

Mothers must carefully ensure that gonorrheal secretions are not transferred in one way or another to the child’s genitals, which can occur either through the use of care items (sponge, towel, soap, bathtubs) used by persons suffering from gonorrhea, or by communicating with caregivers who are sick with gonorrhea.

This should make the mother take care that the child does not come into contact with strangers. Of course, it is unacceptable to use someone else's soap, towel, bedpan, sponge, etc. It is very important that the child sleeps in a separate bed and under no circumstances sleeps with adults. If the mother herself is sick with gonorrhea, then it is all the more necessary to maintain cleanliness when caring for the child.

Prevention of gonorrhea in children's institutions should be carried out through regular examinations of children and staff with immediate isolation of the sick. It is necessary to carefully monitor the cleanliness of restrooms and bathrooms.

How about a disease of a venereal nature (that is, transmitted primarily through sexual contact). This is, of course, a correct idea, but young children can also get gonorrhea, since the infectious agent enters their body through everyday means. Most often this is possible if there is a carrier of the infection in the family, school, kindergarten, health camp, etc. Infection usually occurs through personal items used by the infected. According to statistics, girls are more susceptible to the disease than boys.

Gonorrhea (gonorrhea) is most often diagnosed in children under 12 years of age. Infection occurs through household routes. In total, there are four main types of infection:

• Through the birth canal. During childbirth, the baby can get gonococci while passing through the birth canal, since pathogens are present in the mother's vagina.
• Contact-household infection. In this case, infection occurs in a kindergarten, school, summer camp or sanatorium, and even at home through the use of the same hygiene items with the infected person.
• Through sexual contact. This option is observed only in adolescents.
• intrauterine infection. The rarest route of infection, according to statistics. In medical practice, there are only 2-3 cases when an infected mother infected the fetus.

Over the past decades, several dozen cases of so-called latent gonorrhea have been recorded. In such cases, the infected person does not notice any symptoms of the presence of the disease, the infection is, so to speak, in “waiting mode”. Activation occurs during a certain shake-up, for example, pregnancy.

Gonorrhea poses a threat not only to the woman's body, but also to the unborn baby. you can find out the features of the course of gonorrhea during pregnancy, whether the disease can be cured and how to reduce the risks for mother and child.

Symptoms

Children's symptoms of gonorrhea may differ slightly from the adult version of the disease. The most common sign of the presence of this infection in newborns is the so-called gonococcal conjunctivitis, which manifests itself in the form of purulent and mucous discharge from the corners of the eyes. This pathology is accompanied by severe swelling of the eyelids and suppuration. Otherwise, the symptoms differ depending on the sex of the child and his age.

Symptoms in girls

Girls are statistically more affected by this disease than boys. They develop an infection with a clearly visible deterioration of their condition in a short time. Signs of gonorrhea in girls:

• frequent urination;
• pain during urination;
• purulent discharge from the vagina;
• in the area of ​​​​the external genital organs there is swelling, redness, and pain in this area.

To these symptoms should be added insomnia, fever and fever. As the disease progresses, urination changes from frequent to uncontrolled. On the underwear you can see abundant purulent smears.

Symptoms in boys

Boys have a chance to catch the infection through the birth canal, as well as with the onset of sexual activity. Household infection is very rare for them. Symptoms are slightly different:

• swelling, redness and inflammation of the head of the penis;
• phimosis;
• purulent discharge from the urogenital canal;
• pain and burning during urination;
• urethritis;
• inflammation and swelling of the foreskin (mobility is limited);
• purulent mucous discharge in the morning.

Diagnostics

The main thing in the diagnostic process when it comes to identifying gonorrhea is laboratory tests. First of all, it is required to bacterioscopic and bacteriological examination of a smear. If at this stage the presence of gonococci in the biomaterial is detected, then further cultural examination is no longer required.

Which smear test do you think is more reliable?

BacterioscopicBacteriological

In children, gonococcal infection is diagnosed by taking a double-sided sample. This allows not only to determine the presence of infection, but also to accurately identify the site of inflammation.

For the most accurate examination, you can ureteroscopy, but it is prohibited during exacerbation of infection. This method of examination is allowed only in the case of a chronic form of diseases.

Treatment

First of all, at the stage of detecting gonorrhea in a baby, a serious investigation is carried out with the parents. If one of the parents has an infection, then you need to find out why the infection was not treated at the stage of pregnancy or before it. If the presence of the disease in the mother was known, then why was the birth not carried out by caesarean section to avoid infecting the child.

Sometimes you can request an examination of the medical personnel who delivered the baby and had contact with the baby. In rare cases, the infection could be transmitted from them.

Treatment of gonococcal conjunctivitis is carried out:

• using antibiotics (from the penicillin series), which are administered intramuscularly;

• eye drops, which are 30% silver nitrate solution.

If the children have already grown up, then the therapy is carried out in a hospital setting. Antibiotics are prescribed. Medicines are selected taking into account the age of the child, as well as clinical indicators.

If inflammation in the perineum persists in young patients, the doctor prescribes herbal baths (most often with chamomile and potassium permanganate), as well as lubricating the genitals with antiseptic ointments. For boys in such cases, silver nitrate or protargol is prescribed (introduced into the urethra).

For girls, gonorrhea is dangerous, first of all, menstrual irregularities and the development of infertility in adulthood.

Gonorrhea is not only the scourge of adulthood. Modern medical practice shows that every year more and more cases of infection with gonococci in children are registered in the world. Whether parental negligence or a domestic accident is to blame is no longer so important; it is important to detect the disease in a child in time and begin prompt treatment. Lack of proper treatment can lead to serious complications in the future.

In this video, your doctor will tell you about the treatment options for gonorrhea in children.

Children have their own specifics, due to the anatomical and physiological characteristics of their genital organs. In particular, boys have a shorter duration of gonorrheal urethritis and rare cases of complications (epididymitis, orchitis, etc.).

For girls the external genitalia are easily accessible to infection. The genital slit is half open. The small distance between the vagina, urethra and rectum facilitates the spread of gonococcal infection. In childhood, the vagina is lined with delicate and thin non-keratinizing transitional epithelium, so gonococci easily penetrate through it, forming diffuse inflammatory lesions of the mucous membrane.
As a rule, girls who are infected at home are more likely to get gonorrhea. In newborns, it occurs during the passage of the child through the infected birth canal, as well as in utero through amniotic fluid. There are known cases of nosocomial infection in maternity wards through care items. Infection can also occur from a mother with gonorrhea while caring for a newborn. Older children usually contract gonorrhea from adults. Cases of infection of children by adults through sexual contact are extremely rare.

Gonorrhea in boys. Infection of boys occurs mainly through sexual contact, and non-sexual transmission, as a rule, occurs only in very young children.
Clinically, gonococcal infection in boys first manifests itself as balanoposthitis, then inflammatory phimosis occurs. Urination is very painful. A large amount of pus containing gonococci is secreted from the glands of the foreskin.
The subacute course of gonorrhea is characterized by slight hyperemia, swelling of the external opening of the urethra and mucopurulent discharge from it in small quantities. There is a torpid and chronic course of gonorrheal urethritis, which is almost not clinically manifested.
In some cases, bilateral epididymitis and abscessing orchitis are observed. Young boys do not suffer from prostatitis and vesiculitis.

Gonorrhea in girls. Gonococcal infection in girls, in addition to the area of ​​the external genitalia and vagina, spreads to the urethra, rectum, and uterus, which, as with gonorrhea in adults, can lead to severe general illness.
Girls are more likely to have fresh gonorrhea. Chronic course is observed relatively rarely. Fresh gonorrhea in most patients is acute, with violent manifestations of the inflammatory process - severe swelling and hyperemia of the mucous membrane of the genital area, significant mucopurulent discharge from the genital fissure. There is hyperemia and swelling of the external opening of the urethra and mucopurulent discharge from it. Urination is frequent and painful. Body temperature may rise.
In the subacute course of the gonococcal process in children, the phenomena of inflammation in the genital area are less intense: hyperemia is mild and focal in nature, mucopurulent discharge from the urethra, vagina is very scanty, there is no dermatitis. During vaginoscopy, clearly defined areas of hyperemia and infiltration are visible on the vaginal walls; a small amount of mucopurulent discharge, mild swelling, hyperemia of the cervix, sometimes erosion around the opening of the uterus and mucopurulent discharge from the cervical canal are found in the vaginal folds. Possible asymptomatic course of fresh gonorrhea. Gonorrhea in girls, as in women, is a multifocal disease: in 100% of patients, the internal genital organs are affected, in 85% - the urethra, in 50-82% - the rectum, in 2-4% - the large glands of the vestibule. In girls with gonorrhea, the cervix is ​​affected in 50-75% of cases, and the uterus is much less often affected.
In acute vulvovaginitis, the skin of the labia majora and minora, as well as the mucous membrane of the vestibule of the vagina, is swollen, hyperemic, covered with mucopurulent discharge, freely flowing from the vaginal opening, the clitoris and hymen are swollen. With a sluggish and chronic course of gonorrhea, focal hyperemia occurs on the mucous membrane of the vaginal vestibule; in some cases, genital warts are found in the area of ​​the vaginal vestibule.
It is possible for the gonococcal process to move to the uterus and above, as a result of which peritonitis sometimes develops with serious consequences. The occurrence of ascending gonorrhea in girls can be facilitated by violation of hygiene rules, irrational treatment, and concomitant diseases.
Frequent cases of gonococcal lesions of the rectum are due to the fact that vaginal discharge containing gonococci easily flows onto the rectal mucosa. Clinically, gonococcal proctitis is asymptomatic; sometimes children complain of burning and itching in the anus. Impurities of pus and mucus can be found in the stool. During rectoscopic examination, hyperemia, edema, bleeding of the rectal mucosa, accumulation of pus between the folds in the form of flakes, shreds, stripes or films similar to diphtheria are noted. Rectal gonorrhea is a difficult to treat, often recurrent disease, therefore, at the slightest suspicion of gonorrheal lesions of the rectum in children, they should be examined by a venereologist.
With gonococcal eye damage, redness, swelling, and gluing of the eyelids are initially observed. Pus flows out from under their edges or the inner corner of the eye, the conjunctiva of the eye becomes hyperemic and swells. If appropriate treatment is not started in a timely manner, ulceration of the cornea, even perforation, is possible, which can subsequently lead to complete blindness.
If during childbirth the baby's face comes into contact with the infected mucous membrane of the mother's birth canal, the mucous membrane of the nose and mouth may also become infected. In children, a few days after birth, mucopurulent discharge appears from the nose, in the mouth, on the surface of the lips, tongue, gums and palate - erosion. In the discharge from the nose and ulcerative surfaces of the mouth, gonococci are found in significant quantities. Often gonococcal lesions of the nose and mouth are combined with gonococcal lesions of the eyes, middle ear, larynx, trachea, pleura or joints.
Gonorrhea in children is diagnosed on the basis of anamnesis, clinical picture of the disease, laboratory examination of patients and persons in contact with them. The final diagnosis is established only on the basis of the detection of typical gonococci in the discharge from the lesions.

The topic of today's article is. As noted, girls become infected through extrasexual contact, usually from women with gonorrhea (mothers, sisters, nannies) with whom they had close contact. Infection can occur when using a washcloth, sponge, chamber pot, or towel that was used by a woman with gonorrhea; and also as a result of staying in a shared bed.

How does gonorrhea manifest in girls?

Gonorrhea in children differs in its manifestations from (due to the different structure of the epithelium of the mucous membranes and the chemical composition of the secretions of the mucous membranes in women and girls).

A common manifestation of gonorrhea in girls is vulvovaginitis - inflammation of the mucous membranes of the external genitalia at the entrance to the vagina and the vaginal mucosa (in adults, as noted, vulvitis and vaginitis are considered rare manifestations).

Girls are more likely to have fresh gonorrhea; occurs acutely, with pronounced inflammatory phenomena - swelling, hyperemia in the area of ​​the external genitalia and vagina; significant mucopurulent discharge from the genital fissure is noted. Soon after this (often simultaneously), gonorrheal urethritis develops. There is hyperemia and swelling of the external opening of the urethra and mucopurulent discharge from it. Urination becomes frequent and painful. Sometimes inflammation of the paraurethral ducts is observed, which can cause relapses of the disease.

As a result of vaginal discharge, the labia stick together and skin irritation occurs in the genital area, perineum, inguinal folds, and inner thighs; this causes itching and burning; redness, swelling, erosions, and crusts appear.

In an acute gonorrheal process, the general condition may be disrupted - malaise, irritability, loss of appetite appear; small children do not want to play, they want to lie down.

In the subacute course of gonorrhea in children, the inflammatory process in the genital area is less intense: hyperemia and swelling are less pronounced and are focal in nature, mucous-purulent discharge from the vagina and urethra is insignificant, and there are no symptoms of dermatitis. An asymptomatic course of fresh gonorrhea is also possible.

In the absence (or the wrong approach), acute gonorrhea in children becomes chronic (sometimes from the very beginning it occurs with symptoms of a chronic process).

With chronic gonorrhea in girls, inflammatory phenomena are mildly expressed - including subjective sensations, redness, swelling around the entrance to the vagina and the external opening of the urethra; mucopurulent discharge becomes scanty; However, it is not always possible to detect gonococci in smears.

Chronic gonorrhea in girls may go undiagnosed for a long time; At the same time, at times, exacerbations of the process and the appearance of symptoms of acute gonorrhea can be observed (for example, after previous infections).

In the chronic gonorrheal process, the cervix may be affected, and much less frequently, the uterus and fallopian tubes.

With endocervicitis, mucopurulent discharge appears from the cervical canal; Around the opening of the uterus, erosions of a round or irregular shape, with uneven edges, and a bright red color may be found.

Less frequently ascending gonorrhea in children accompanied by salpingitis (sometimes proceeds like “unclear” forms of appendicitis).

As a result of pus entering the anus, gonorrheal inflammation of the rectal mucosa may occur. With gonorrheal proctitis, children complain of burning, itching in the anus; redness and swelling appear around the anus; sometimes cracks form; Mucopurulent discharge flows from the anus (stool may become painful; impurities of pus and mucus can be found in the stool). If rectal gonorrhea is suspected, children should be urgently referred for examination to a venereologist!

The diagnosis is confirmed by laboratory tests (smears should be taken with extreme caution - with a dull spoon) - gonococci are found in the discharge of the vagina, urethra and anus during gonorrhea.