Prevention and treatment of gonorrhea, chancroid and genital herpes simplex

347. What should I do if I get gonorrhea?

Gonorrhea is short for gonococcal urethritis, a disease caused by Neisseria gonorrhoeae.

Sexually transmitted diseases. Sexual intercourse is the main route of transmission. Both men and women can develop this disease.

In this disease, it is more common in men than women, and the age of onset is trending younger.

Generally, the age range is between 20 and 24, and even lower for women. Statistics show that...

This disease ranks first among the five major sexually transmitted diseases, with an extremely high incidence rate. This situation is even more pronounced in European and American countries.

It is now extremely prominent.

Clinically, gonorrhea symptoms are more pronounced in men than in women, generally occurring in...

Symptoms can appear 2-3 days after sexual intercourse with a woman infected with gonorrhea. Early symptoms mainly include...

The patient currently presents with symptoms of acute urethritis, initially accompanied by redness, swelling, and itching at the urethral opening, along with a slight stinging sensation.

Pain, burning pain during urination, followed by a small amount of thin, clear mucus discharge from the urethra.

A few days later, urethral discharge increased, and the mucus became thick and purulent, resembling nasal discharge.

It is milky white, hence the traditional Chinese medicine term "lin zhuo" (淋浊). As the condition progresses, it can...

The urethral opening mucosa is red and swollen, the penis is enlarged, and the discharge is thick, yellowish-green, and continuous.

Outflow. Contamination of clothing and towels can cause gonococcal conjunctivitis. For example...

If bacteria invade the bloodstream, they can cause endocarditis, arthritis, and sepsis.

If a local infection causes capillary rupture, a small amount of bleeding may be observed.

If this disease is not treated promptly or thoroughly during the acute phase, it may progress to other complications.

It is chronic. At this stage, urethral irritation symptoms persist, accompanied by increased frequency of nocturia.

Discomfort in the genital area. There is still urethral discharge, but it has become thinner and less noticeable in the urine.

"Wool-like" discharge may appear, often sealing the urethral opening. This is due to urine...

Edema of the urethral mucosa can lead to proliferation of fibrous tissue, and in 90% of cases, it can result in urethral stricture.

Narrowing can cause difficulty urinating. If the lesion affects surrounding tissues and organs, it can cause problems with the urethra.

Inflammatory lesions of the prostate, epididymis, and testes can cause infertility.

The treatment of gonorrhea, like that of other diseases, emphasizes early detection and treatment.

Words. Strive for early detection, early isolation, and early treatment. Penicillin is the first-line treatment during the acute phase.

The medication was administered as a single injection of 4.8 million units, divided into two doses in the buttocks. This was given before the intramuscular injection of penicillin.

Administer 1.0 g of probenecid orally within 30 minutes, for one week. Other antibiotics may also be used.

Use as appropriate. For urethral pain, antispasmodic drugs such as urinary tract infection medication (e.g., 200 ml) can be added.

Take 10 grams orally three times a day. Alternatively, you can use traditional Chinese medicine: 10 grams each of Polyporus umbellatus, Alisma plantago-aquatica, and Phellodendron chinense.

Take 15 grams of talc and 10 grams of water. Decocted in water and taken orally, one dose per day, can also achieve good results.

During treatment, both partners should be treated simultaneously; simultaneous treatment is absolutely prohibited.

Sexual intercourse; abstain from alcohol; store clothing separately and disinfect at high temperatures; clean secretions promptly and wash the vulva frequently.

348. How should chancroid be treated?

Chancroid is a relatively common sexually transmitted disease caused by Streptococcus chancroid.

A type of genital ulcer. Transmission occurs through unprotected sexual intercourse, especially via carriers of sexually transmitted infections.

The bacteria can be transmitted through sexual contact. It primarily affects men, but women can also be infected.

It can cause the disease. The male-to-female ratio of incidence is 10:1.

What are the symptoms of chancroid? Generally, symptoms appear about one week after unprotected sexual intercourse.

Symptoms will appear inside the penis. In men, it commonly occurs on the foreskin, coronal sulcus, glans penis, anus, and...

The frenulum of the prepuce. In female patients, it commonly occurs on the labia majora and minora, clitoris, urethra, and uterus.

Anus. In the early stages of the disease, congested papules appear at the affected area, which quickly turn into vesicles and...

Pustules, with redness around the lesions. After the pustules rupture, ulcers form; the ulcers are round.

Shaped, oval, or irregular; covered with grayish-white purulent discharge, upon removal of pus.

After the ulcer crusts fall off, bright red granulation tissue is visible, which bleeds easily and is significantly tender. Initially...

It started as a single ulcer, which later became infected due to pus discharge, leading to multiple ulcers on the surrounding skin.

Ulcerated surfaces (usually 2-5). Several adjacent ulcers can create a large, irregular area.

The ulcerative lesion is located on the groin. One to two weeks after the ulcer appears, the inguinal lymph nodes are affected.

Inflammation, swelling, and pain. If treatment is not timely or diagnosis is delayed, it may rupture and drain.

Yellow pus formed a fistula.

What medications are used to treat chancroid? Currently, sulfonamides are considered the most effective.

Medication is the first choice; sulfamethoxazole can be used, 4 grams daily for 10-20 days.

To enhance its efficacy, it can be taken concurrently with sulfonamide potentiators. Alternatively, tetracycline 0.5 grams can be used.

Four times daily for 15 consecutive days; kanamycin 0.5g, intramuscular injection, two to three times daily.

Using it for 7 consecutive days also has a certain therapeutic effect.

In addition, the genital area should be kept clean; a solution of 1:4000 or 1:6000 can be used.

Wash the affected area with gentian violet solution. Sulfonamide ointments can also be applied topically. If the lesion is large...

For mild cases without suppuration, local warm compresses can be applied, or a syringe can be used to apply heat to the suppurating area.

The pus was aspirated from the cavity, and then the prepared sulfonamide drugs were injected into the cavity.

After bandaging, in more severe cases, incision and drainage may be necessary.

It should also be noted that this medication should not be taken internally until syphilis has been ruled out.

Alternatively, administer anti-syphilis medication; if a comprehensive examination confirms that syphilis has been ruled out, and a diagnosis of syphilis is made...

Those with chancroid can be treated as chancroid patients.

349. How to prevent and treat genital herpes simplex?

Genital herpes simplex is caused by the herpes simplex virus and is transmitted through sexual contact.

It is a sexually transmitted disease. It is highly contagious, and the incidence rate is high after sexual contact.

The incidence rate is as high as 30% to 50%. Promiscuity or unsafe sexual practices are the "source" of this disease.

The patient has genital herpes and had sexual contact with an infected person before the onset of the disease.

Typically, after 3 to 5 days, several small red papules or blisters appear on the vulva, densely clustered together.

Clustered. In male patients, it commonly occurs on the foreskin, glans, and coronal sulcus of the penis, and is occasionally seen.

The urethral opening; in female patients, the lesions may occur on the labia majora, mons pubis, clitoris, or cervix.

Before blisters appear, most patients feel a burning sensation in the affected area, but many others do not experience this discomfort.

Then, the blisters gradually turn into pustules, which rupture and form ulcers, causing pain. Afterwards...

The scab heals. If the lesion affects the urethral opening, difficulty urinating may occur. If it is combined with...

When herpetic urethritis and cystitis occur, urethral discharge increases and becomes clear and sticky.

The more fluid secreted, the more severe the dysuria.

About half of the patients with the primary disease develop swollen inguinal lymph nodes, locally.

There is tenderness, and there may also be more obvious systemic symptoms, such as headache and fever.

When women first contract this disease, about 70% also experience endometritis, cervical redness, swelling, and ulceration.

There is a large amount of purulent vaginal discharge. In the second week of the illness, discharge may also occur outside the genitals.

Herpes lesions appear on various parts of the body, commonly on the upper limbs, groin, fingers, and eyes.

Genital herpes simplex is caused by a viral infection, and there is currently no antiviral treatment for it.

A specific drug for poisoning. Treatment varies depending on the individual case, aiming to alleviate symptoms and shorten the course of the disease.

Reduce recurrence. The new antiviral drug acyclovir can selectively inhibit viral replication, while...

It has low toxicity and can be tried. The dosage is 200 mg each time, four times a day, for 2-3 days.

A cure can be achieved in 7 days. If administered intravenously, the dosage is 5-15 mg per kilogram of body weight.

The dosage is the total daily dose, divided into three injections per day for three consecutive days. If secondary infection occurs...

In such cases, 800,000 units of penicillin and 0.5 grams of streptomycin can be mixed and injected intramuscularly.

Apply twice daily for two weeks. Locally, wash with a 1:6000 methyl violet solution.

Apply erythromycin ointment topically. Sexual activity should be avoided during treatment.