This disease develops when it enters the conjunctival cavity of Neisser gonococcus . The disease occurs in adults suffering from Gono coccoid urethritis, children infected by sick parents, medical personnel dealing with patients. Disease is especially severe in newborns GOVERNMENTAL. Infection of the newborn occurs during childbirth when the fetus passes through the birth canal of a mother with a gonorrhea. The disease begins on the 2nd – 3rd day after birth. A pronounced cyanotic-purple swelling of the eyelids appears. Swollen eyelids become so dense that it is almost impossible to open them for eye examination. Thus from canthus blood pressure poured oily discharge color of meat slops. On the 4th – 5th day, edema of the eyelids decreases and profuse purulent discharge appears. On the edges of the eyelids pus dries up, tight gluing them, and in the conjunctival sac accumulates more and more purulent discharge, and therefore, when the races kryvayut eyelids, purulent discharge stream flows. In this regard, when examining a child with conjunctivitis, in which the eyelids and their edges are glued together with pus, you need to be careful that the splashes of the purulent discharge from the patient’s eye do not get into the eye of a medical professional. Eye protection medical skie workers must wear protective goggles.
With untimely or improper treatment, gonoblenorrhea can cause serious complications such as a creeping corneal ulcer. Such an ulcer can completely destroy the cornea, as a result of which purulent infiltration spreads to the inner membranes and contents of the eye, which usually leads to its death.
Diagnosis gonoblennorei eyes placed on the typical clinical picture of lesions of the conjunctiva and Ba Vania bacteriological smears with conjunctions tivy to identify Neisseria gonorrhoeae.
Emergency first aid.
- The edges of the eyelids of a sick child should be cleaned from the discharge vat GOVERNMENTAL swab moistened with a weak solution of potassium permanganate , carefully open the eye slit, so as not to damage the cornea, and rinse thoroughly with sick eyes weakly bym solution of potassium permanganate (1: 5000) of the syringe,
- Drip into the conjunctival sac 30% solution sul fatsil sodium , 0.25% solution of chloramphenicol or a few drops of fresh penicillin solution (100 000 units 1 ml). Repeat this procedure every 1-2 hours.
Treatment is carried out together with a venereologist.
- Desig chayut tend general treatment with antibiotics (fine tsillin, erythromycin, chloramphenicol, tetracyclines, tseporin ) and sulfa drugs and (norsulfazol, etazol , sulfapiridazin ) at doses corresponding to WHO grow.
- Eyes were washed with a solution of potassium permanganate, 1: 5000 or furatsilina 1: 5000, and every 2 hours Zack really adequate solution of the sodium salt of benzylpenicillin in breeding 100,000 units per 1 ml or solutions other antibioti Cove and (or) 30% solution sulfatsil -sodium.
- At night over the eyelids lay bactericidal ointments.
- With a long course of the disease, not accompanied by damage to the cornea, you can cauterize the mucous membrane of the eyelids and the transitional fold with a 1% solution of silver nitrate. Ak tive local treatment lasts for about 2 weeks . Binding tion repeated bacteriological smear from a conjunctiva.
Prevention of gonoblenrhea in our country in newborns is mandatory. Immediately after rye Denia baby wipe lids with a cotton swab wetted nym 2% boric acid solution and instilled 1% silver nitrate solution into each eye. It is necessary to strictly follows dit to erroneously was not used 10-20% silver nitrate solution, which is sometimes used in maternity wards for treatment of the umbilical cord. Erroneous Zacapa vanie eye 10% newborn se nitrate solution ribs cause severe burns of the cornea followed yuschim form leukomas and even loss of the eye.
In this regard, instead of silver nitrate, a 30% solution of sulfacyl sodium or a freshly prepared antibiotic solution, which is installed three times within an hour, is now used. Mainly in the prevention gonoblennorei newborns GOVERNMENTAL are repeated thorough examination of women during pregnancy, early and aggressive treatment of their antenatal clinics.
Care of patients with blennophthalmia conclude eye chaetsya:
- in their strict isolation,
- frequent eye washings with a heated solution of potassium permanganate,
- at zabole Vania one eye to the healthy eye bandage with a watch glass to protect it from the entry of infection.
It is recommended that the newborn be laid on the side of the diseased eye so that the purulent discharge does not flow into the healthy eye during sleep. Nurse should thoroughly disinfect items that were in use the patient as well as to make sure that it does not ka salsya century hands, and wash your hands often, to strictly observe the rules of hygiene when caring for patients blennophthalmia eyes.