Overview.
Gonococcal proctitis is a gonorrheal disease of the rectal columnar mucosa, a type of proctitis, mostly seen in male homosexuals. Clinical manifestations are anal itching, pain or swelling, aggravated by defecation, with purulent discharge. Physical examination shows that the rectal mucosa is swollen, eroded and oozing blood. Gonorrheal proctitis is an incurable disease and should be treated actively.
Etiology
Anal mucous membrane wall is thin, non-normal form of genitalia, after anal intercourse, so that a large number of gonorrhea bacteria invade the mucous membrane of the area and become ill.
Symptoms
Symptoms of rectal gonorrhea infection may be only anal itching, painless mucus-like purulent discharge, or a small amount of bleeding, or may be manifested by an urgency, with purulent stools, congestion of the mucous membranes of the anal canal, and purulent discharge.
Examination
1. Smear examination
Take the urethral secretion or cervical secretion of the patient, make gram stain, and find gram-negative diplococci in polymorphonuclear leukocytes.
2. Culture test
Gonococcal culture is an important supporting evidence for diagnosis. Culture is a sensitive method for male and female patients with mild or no symptoms, and the diagnosis can be confirmed as long as the culture is positive. Before the introduction of genetic diagnosis, culture was the only method recommended by the World Health Organization to screen for gonorrhea.
Diagnosis
Gonorrheal proctitis is not difficult to diagnose and can be correctly diagnosed on the basis of its clinical presentation, history and necessary investigations. The patient has a history of unclean sexual contact and external genital lesions.
Rectal palpation may have a burning sensation and intra-anal pressure; anoscopy or proctoscopy reveals rectal mucosal congestion, edema, and yellowish-white secretion.
Laboratory examination, anal secretion culture of gonococcus, is the most important basis for diagnosis.
Treatment
The treatment of gonococcal proctitis is based on antibacterial and anti-inflammatory, using anti-Gram-negative bacteria drugs or broad-spectrum antibiotics, and there are four routes of administration: oral, intramuscular injection, intravenous drip and retention enema.
1. Oral medicine
Haloperidol tablets, erythromycin tablets, oxytetracycline tablets, levofloxacin tablets.
2. Intramuscular injection
Cefotrizine (Bacteriophage), Spectinomycin (Gonorrhea).
3. Intravenous drip
Gentamicin, ampicillin, levofloxacin.
4.Retention enema
Gentamicin or levofloxacin, also can use cefotrizine or spectacularin once a day retained enema.
Prevention
1. Publicize the knowledge of sexually transmitted diseases, advocate noble moral sentiments, and strictly prohibit prostitution.
2. The use of condoms can reduce the incidence of gonococcal infection.
3. Prophylactic use of antibiotics can reduce the risk of infection. You can take haloperidol or amoxicillin before and after sexual intercourse, which can effectively prevent the infection of STDs.
4. Sexual partners should be treated at the same time.
5. Patients should pay attention to personal hygiene and isolation.