bệnh dịch lậu vì chưng vi khuẩn tạo Neisseria gonorrhoeae. Chúng thường nhiễm vào biểu mô của niệu đạo, cổ tử cung, trực tràng, hầu họng, hoặc kết mạc, gây kích ứng hoặc đau & xuất huyết rải rác. Khuếch tán tới domain authority and khớp, là không thông thường, xây dừng vết loét bên trên domain authority, sốt, và viêm nhiều khớp di cư hoặc viêm xương khớp nhiễm khuẩn. Chẩn đoán bởi kính hiển vi, nuôi ghép, hoặc cụm xét nghiệm khuếch đại acid nucleic. 1 Số chất kháng sinh đường uống hoặc tiêm được thực hiện, tuy nhiên chống thuốc là một việc càng ngày tăng.
N. Gonorrhoeae là một vi khuẩn gram âm hình cầu xếp đôi cơ mà chỉ xảy ra ở người thân và đầy đủ luôn luôn được truyền qua quan hệ tình dục. Nhiễm trùng niệu đạo and cổ tử cung là tầm thường nhất, cơ mà nhiễm trùng ở họng hoặc trực tràng có lẽ xảy ra sau khi quan hệ tình dục miệng hoặc hậu môn, and viêm mắt dường như theo sau sự nhiễm không sạch mắt.
Sau khi lần quan hệ tình dục qua đường âm đạo, tính năng lây truyền từ nữ giới sang Đấng mày râu chặng 20%, nhưng mà từ nam sang con gái, có vẻ cao hơn. Trẻ sơ sinh và bị nhiễm trùng kết mạc khi sinh thường (xem Nguyên nhân), và trẻ em có thể bị bệnh dịch lậu vày lạm dụng tình dục.
Ở 10 đến 20% đàn bà,từ nhiễm trùng cổ tử cung lan lên qua nội mạc tử cung mang đến cụm ống dẫn trứng (viêm phòng trứng) and phúc mạc chốn chậu, thi công bệnh viêm tiểu khung (PID). Chlamydiae hoặc vi khuẩn mặt đường ruột Có thể tạo ra PID. Viêm cổ tử cung vị lậu cầu thường đi kèm mang triệu chứng cạnh tranh tiểu hoặc viêm ống Skene and con đường Bartholin. Ở một phần nhỏ dại phái mạnh, viêm niệu đạo có lẽ tiến triển mang đến viêm mào tinh hoàn.
Nhi&#7877;m gonococcal lan to&#7843; (DGI) v&#7883; s&#7921; l&#226;y lan trong m&#225;u t&#7841;o ra < 1% tr&#432;&#7901;ng h&#7907;p, ch&#7911; y&#7871;u &#7903; c&#244; b&#233;. DGI th&#432;&#7901;ng t&#225;c &#273;&#7897;ng cho da, bao g&#226;n v&#224; kh&#7899;p. Vi&#234;m m&#224;ng kh&#244;ng t&#237;nh tim, vi&#234;m n&#7897;i tr&#7885;ng &#273;i&#7875;m m&#7841;c, vi&#234;m m&#224;ng n&#227;o and vi&#234;m bao k&#7871; b&#234;n gan hi&#7871;m khi x&#7843;y ra.
&#272;&#7891;ng nhi&#7877;m c&#243; Chlamydia trachomatis x&#7843;y ra t&#7915; 15 &#273;&#7871;n 25% &#273;&#7841;i tr&#432;&#7907;ng phu b&#7883; d&#7883; t&#237;nh & 35 &#273;&#7871;n 1/2 ph&#7909; n&#7919;.
[b]tri&#7879;u ch&#7913;ng & b&#7897;c l&#7897;[/b]
ch&#7863;ng 10 cho 20% n&#7919; b&#7883; nhi&#7877;m and r&#7845;t &#237;t c&#225;nh m&#224;y r&#226;u b&#7883; nhi&#7877;m kh&#244;ng c&#243; tri&#7879;u ch&#7913;ng. Ch&#7863;ng 25% nam nhi g&#7891;m b&#7879;nh bu&#7893;i t&#7889;i thi&#7875;u.
Vi&#234;m ni&#7879;u &#273;&#7841;o &#7903; nam t&#7845;t c&#7843; th&#7901;i k&#7923; &#7911; d&#7883;ch t&#7915; 2 &#273;&#7871;n 14 ng&#224;y. Kh&#7903;i ph&#225;t th&#432;&#7901;ng bao g&#7891;m bi&#7875;u &#273;&#7841;t c&#7843;m th&#7845;y kh&#244;ng tho&#7843;i m&#225;i &#7903; ni&#7879;u &#273;&#7841;o, ti&#7871;p theo l&#224; &#273;au & &#273;au nh&#7913;c sinh d&#7909;c nam n&#7863;ng h&#417;n, h&#7897;i ch&#7913;ng kh&#243; ni&#7879;u and t&#232; m&#7911;. T&#7847;n su&#7845;t ti&#7871;t n&#432;&#7899;c &#273;&#225;i and b&#7889;i c&#7843;nh c&#7845;p b&#225;ch h&#236;nh nh&#432; ti&#7871;n tri&#7875;n khi nhi&#7877;m tr&#249;ng l&#226;y lan mang l&#7841;i ni&#7879;u &#273;&#7841;o sau. Kh&#225;m ch&#7845;t v&#7845;n ph&#225;t hi&#7879;n ra m&#7911; ni&#7879;u &#273;&#7841;o m&#224;u v&#224;ng-xanh, and l&#7895; t&#232; v&#224; b&#7883; vi&#234;m.
[b]b&#7879;nh l&#7853;u (vi&#234;m ni&#7879;u &#273;&#7841;o)[/b]
Vi&#234;m m&#224;o tinh th&#432;&#7901;ng g&#226;y ra &#273;au b&#236;u solo, &#273;au, and s&#432;ng t&#7845;y. Hi&#7871;m khi, &#7903; con trai ti&#7871;n tri&#7875;n th&#224;nh ap xe c&#7911;a nh&#7919;ng tuy&#7871;n Tyson & Littre, &#225;p xe quanh ni&#7879;u &#273;&#7841;o, ho&#7863;c nhi&#7877;m tr&#249;ng con &#273;&#432;&#7901;ng Cowper, tuy&#7871;n &#273;&#432;&#7901;ng ti&#7873;n li&#7879;t, ho&#7863;c t&#250;i tinh.
Vi&#234;m c&#7893; t&#7917; cung th&#432;&#7901;ng t&#7845;t c&#7843; th&#7901;i k&#7923; &#7911; c&#259;n b&#7879;nh > 10 ng&#224;y. Bi&#7875;u hi&#7879;n t&#7915; nh&#7865; &#273;&#7871;n n&#7863;ng & bao g&#7891;m t&#7845;t c&#7843; kh&#243; t&#232; ti&#7879;n & ra c&#259;n b&#7879;nh &#226;m &#273;&#7841;o. Trong qu&#225; tr&#236;nh kh&#225;m v&#249;ng ch&#7853;u, B&#225;c S&#7929; l&#226;m s&#224;ng c&#243; l&#7869; &#272;&#7875; &#253; &#273;&#7871;n nh&#7847;y m&#7911; c&#7893; t&#7917; cung ho&#7863;c n&#432;&#7899;c m&#7911;, and c&#7893; t&#7917; cung gi&#7889;ng nh&#432; l&#224;m n&#234;n m&#224;u &#273;&#7887; and b&#7883; ch&#7843;y m&#225;u m&#7897;t c&#225;ch d&#7877; d&#224;ng khi va b&#7903;i d&#7909;ng c&#7909;. Vi&#234;m ni&#7879;u &#273;&#7841;o ch&#7855;c l&#224; th&#224;nh l&#7853;p &#273;&#7891;ng th&#7901;i; m&#7911; ch&#7855;c l&#224; ch&#7843;y ra t&#7915; ni&#7879;u &#273;&#7841;o khi &#233;p kh&#7899;p mu ho&#7863;c t&#7915; c&#225;c &#7889;ng Skene ho&#7863;c tuy&#7871;n &#273;&#432;&#7901;ng Bartholin. Hi&#7871;m khi, nhi&#7877;m tr&#249;ng &#7903; tr&#7867; v&#236; ch&#432;ng th&#224;nh ni&#234;n b&#7883; l&#7841;m d&#7909;ng t&#236;nh d&#7909;c desgin b&#7879;nh c&#7921;c nh&#7885;c &#273;&#225;i, ra m&#7911; ch&#7895; k&#237;n and k&#237;ch &#7913;ng &#226;m h&#7897;, &#273;&#7887; da v&#224; ph&#249;.
[b]b&#7879;nh l&#7853;u (Vi&#234;m &#226;m &#273;&#7841;o)[/b]
PID x&#7843;y ra trong 10 &#273;&#7871;n 20% c&#244; g&#225;i b&#7883; nhi&#7877;m b&#7879;nh d&#7883;ch. PID h&#236;nh nh&#432; bao g&#7891;m vi&#234;m v&#242;i tr&#7913;ng, vi&#234;m ph&#250;c m&#7841;c ch&#7889;n ch&#7853;u v&#224; &#225;p xe khung ch&#7853;u v&#224; c&#243; th&#7875; g&#226;y c&#7841;nh tranh ch&#7883;u &#7903; b&#7909;ng d&#432;&#7899;i (th&#432;&#7901;ng l&#224; hai b&#234;n), &#273;au khi quan h&#7879;, and &#273;au khi th&#259;m kh&#225;m v&#249;ng b&#7909;ng, ph&#7847;n ph&#7909;, ho&#7863;c c&#7893; t&#7917; cung.
b&#7879;nh Fitz-Hugh-Curtis c&#259;n b&#7879;nh vi&#234;m bao quanh gan gonococcal (ho&#7863;c chlamydia) x&#7843;y ra bao g&#7891;m &#7903; n&#224;ng & g&#226;y &#273;au h&#7841; s&#432;&#7901;n n&#234;n, &#7889;m, bu&#7891;n n&#244;n & n&#244;n m&#7917;a, th&#432;&#7901;ng gi&#7889;ng c&#259;n b&#7879;nh &#273;&#432;&#7901;ng m&#7853;t hay gan.
L&#7853;u c&#7847;u tr&#7921;c tr&#224;ng th&#432;&#7901;ng ch&#432;a t&#7845;t c&#7843; b&#7879;nh. N&#243; x&#7843;y ra ch&#237;nh &#7903; &#272;&#7845;ng m&#224;y r&#226;u bao g&#7891;m quan h&#7879; t&#236;nh d&#7909;c &#273;&#7891;ng t&#237;nh ti&#7871;p nh&#7853;n and gi&#7889;ng nh&#432; x&#7843;y ra &#7903; c&#244; g&#225;i gia nh&#7853;p quan h&#7879; t&#236;nh d&#7909;c qua &#273;&#432;&#7901;ng h&#7853;u m&#244;n. B&#7879;nh t&#7853;t bao g&#7891;m t&#7845;t c&#7843; ng&#7913;a tr&#7921;c tr&#224;ng, ra c&#259;n b&#7879;nh &#273;&#7909;c tr&#7921;c tr&#224;ng, b&#7883; ra m&#225;u, & apple b&#243;n-t&#7845;t c&#7843; nh&#7919;ng ch&#7915;ng &#273;&#7897; r&#7845;t l&#7899;n kh&#225;c nhau. Ki&#7875;m so&#225;t s&#7917; d&#7909;ng m&#225;y soi d&#432;&#7901;ng nh&#432; ph&#225;t hi&#7879;n th&#7845;y ban &#273;&#7887; ho&#7863;c nh&#7847;y m&#7911; tr&#234;n th&#224;nh tr&#7921;c tr&#224;ng.
Vi&#234;m h&#7885;ng b&#7903;i l&#7853;u c&#7847;u th&#432;&#7901;ng kh&#244;ng b&#7879;nh t&#7853;t tuy v&#7853;y c&#243; l&#7869; g&#226;y &#273;au h&#7885;ng. N. Gonorrhoeae n&#234;n &#273;&#432;&#7907;c r&#245; r&#224;ng mang N. Meningitidis v&#224; nhi&#7873;u lo&#224;i v&#7853;t c&#243; &#7843;nh h&#432;&#7903;ng li&#234;n quan nghi&#234;m nh&#7863;t kh&#225;c th&#432;&#7901;ng c&#243; m&#7863;t c&#7893; h&#7885;ng nh&#432;ng ch&#432;a g&#226;y tri&#7879;u ch&#7913;ng ho&#7863;c g&#226;y h&#7841;i.
Nhi&#7877;m tr&#249;ng c&#7847;u khu&#7849;n lan t&#7887;a lan (DGI), c&#242;n g&#7885;i l&#224; h&#7897;i ch&#7913;ng vi&#234;m kh&#7899;p-vi&#234;m da, ph&#7843;n &#225;nh b&#7889;i c&#7843;nh nhi&#7877;m tr&#249;ng m&#225;u & th&#432;&#7901;ng tri&#7879;u ch&#7913;ng s&#7903; h&#7919;u &#7889;m, &#273;au v&#7853;n t&#7843;i ho&#7863;c s&#432;ng kh&#7899;p (vi&#234;m nhi&#7873;u kh&#7899;p) v&#224; t&#7893;n th&#432;&#417;ng da b&#7883; m&#7909;n m&#7911;. &#7902; m&#7897;t s&#7889; ng&#432;&#7901;i b&#7879;nh, &#273;au ti&#7871;n tri&#7875;n and g&#226;n (v&#237; d&#7909;, &#7903; c&#7893; tay ho&#7863;c m&#7855;t c&#225; ch&#226;n) &#273;&#7887; ho&#7863;c s&#432;ng. Nhi&#7873;u t&#7893;n th&#432;&#417;ng domain authority th&#432;&#7901;ng x&#7843;y ra &#7903; c&#225;nh tay ho&#7863;c ch&#226;n, c&#243; n&#7873;n &#273;&#7887;, v&#224; nh&#7887; d&#7841;i, h&#417;i &#273;au, v&#224; th&#432;&#7901;ng b&#7883; m&#7909;n m&#7911;. L&#7853;u sinh d&#7909;c, ngu&#7891;n l&#226;y truy&#7873;n ph&#7893; bi&#7871;n, ch&#7855;c l&#224; kh&#244;ng c&#243; b&#7879;nh t&#7853;t. DGI c&#243; l&#7869; A dua c&#225;c r&#7889;i lo&#7841;n kh&#225;c g&#226;y s&#7889;t, t&#7893;n th&#432;&#417;ng da, and vi&#234;m nhi&#7873;u kh&#7899;p (v&#237; d&#7909;, t&#236;nh tr&#7841;ng vi&#234;m gan B ho&#7863;c m&#224;ng n&#227;o c&#7847;u); 1 s&#7889; &#237;t nhi&#7873;u r&#7889;i lo&#7841;n kh&#225;c c&#361;ng thi c&#244;ng b&#7879;nh sinh d&#7909;c (v&#237; d&#7909;:, vi&#234;m kh&#7899;p ph&#7843;n &#7913;ng).
[b]L&#7853;u (t&#7893;n th&#432;&#417;ng da)[/b]
c&#259;n b&#7879;nh vi&#234;m kh&#7899;p do nhi&#7877;m l&#7853;u c&#7847;u ch&#237;nh l&#224; d&#7841;ng DGI c&#7909;c b&#7897; h&#417;n k&#233;o theo vi&#234;m kh&#7899;p &#273;au mang tr&#224;n d&#7883;ch, th&#432;&#7901;ng l&#224; 1 ho&#7863;c 2 kh&#7899;p to nh&#432; &#273;&#7847;u g&#7889;i, m&#7855;t c&#225; ch&#226;n, c&#7893; tay, ho&#7863;c khu&#7927;u tay. M&#7897;t s&#7889; &#237;t ng&#432;&#7901;i b&#7883; b&#7879;nh g&#7891;m ho&#7863;c g&#7891;m ti&#7873;n s&#7917; t&#7893;n th&#432;&#417;ng da c&#7911;a DGI. S&#7921; kh&#7903;i ph&#225;t th&#432;&#7901;ng si&#234;u cung c&#7845;p t&#237;nh, th&#432;&#7901;ng b&#7883; c&#7843;m c&#250;m, &#273;au kh&#7899;p &#193;c d&#7897;i, and lo&#7841;i tr&#7915; di chuy&#7875;n. C&#225;c kh&#7899;p b&#7883; nhi&#7877;m s&#432;ng l&#234;n, v&#224; domain authority k&#7871; b&#234;n gi&#7889;ng nh&#432; &#7845;m & &#273;&#7887;.
d&#7883;ch l&#7853;u v&#7883; vi khu&#7849;n t&#7841;o ra Neisseria gonorrhoeae. Ch&#250;ng th&#432;&#7901;ng nhi&#7877;m v&#224;o bi&#7875;u m&#244; c&#7911;a ni&#7879;u &#273;&#7841;o, c&#7893; t&#7917; cung, tr&#7921;c tr&#224;ng, h&#7847;u h&#7885;ng, ho&#7863;c k&#7871;t m&#7841;c, g&#226;y k&#237;ch &#7913;ng ho&#7863;c &#273;au & xu&#7845;t huy&#7871;t r&#7843;i r&#225;c. Khu&#7871;ch t&#225;n t&#7899;i da v&#224; kh&#7899;p, l&#224; kh&#244;ng chung, x&#226;y d&#7915;ng v&#7871;t lo&#233;t tr&#234;n da, &#7889;m, v&#224; vi&#234;m nhi&#7873;u kh&#7899;p di c&#432; ho&#7863;c vi&#234;m x&#432;&#417;ng kh&#7899;p nhi&#7877;m khu&#7849;n. Ch&#7849;n &#273;o&#225;n b&#7903;i k&#237;nh hi&#7875;n vi, nu&#244;i gh&#233;p, ho&#7863;c nhi&#7873;u x&#233;t nghi&#7879;m khu&#7871;ch &#273;&#7841;i acid nucleic. M&#7897;t s&#7889; &#237;t kh&#225;ng sinh &#273;&#432;&#7901;ng u&#7889;ng ho&#7863;c ti&#234;m &#273;&#432;&#7907;c th&#7921;c hi&#7879;n, d&#7851;u v&#7853;y ch&#7889;ng thu&#7889;c l&#224; m&#7897;t b&#224;i to&#225;n c&#224;ng ng&#224;y c&#224;ng t&#259;ng.
N. Gonorrhoeae l&#224; m&#7897;t vi khu&#7849;n gram &#226;m h&#236;nh c&#7847;u x&#7871;p &#273;&#244;i c&#417; m&#224; ch&#7881; x&#7843;y ra &#7903; ng&#432;&#7901;i th&#226;n & h&#7891; h&#7871;t lu&#244;n lu&#244;n &#273;&#432;&#7907;c truy&#7873;n qua quan h&#7879; t&#236;nh d&#7909;c. Nhi&#7877;m tr&#249;ng ni&#7879;u &#273;&#7841;o v&#224; c&#7893; t&#7917; cung l&#224; t&#7847;m th&#432;&#7901;ng nh&#7845;t, d&#7851;u v&#7853;y nhi&#7877;m tr&#249;ng &#7903; h&#7885;ng ho&#7863;c tr&#7921;c tr&#224;ng h&#236;nh nh&#432; x&#7843;y ra sau khi quan h&#7879; t&#236;nh d&#7909;c mi&#7879;ng ho&#7863;c h&#7853;u m&#244;n, & vi&#234;m m&#7855;t ch&#7855;c l&#224; theo sau s&#7921; nhi&#7877;m kh&#244;ng s&#7841;ch m&#7855;t.
Sau khi l&#7847;n quan h&#7879; t&#236;nh d&#7909;c qua &#273;&#432;&#7901;ng &#226;m h&#7897;, b&#7843;n l&#297;nh l&#226;y truy&#7873;n t&#7915; c&#244; b&#233; sang &#272;&#7845;ng m&#224;y r&#226;u ch&#7863;ng 20%, tuy th&#7871; t&#7915; nam sang ch&#7883; em, c&#243; th&#7875; cao h&#417;n. Tr&#7867; s&#417; sinh c&#243; th&#7875; b&#7883; nhi&#7877;m tr&#249;ng k&#7871;t m&#7841;c khi sinh th&#432;&#7901;ng (xem Nguy&#234;n nh&#226;n), & tr&#7867; em c&#243; th&#7875; b&#7883; c&#259;n b&#7879;nh l&#7853;u b&#7903;i v&#236; l&#7841;m d&#7909;ng t&#236;nh d&#7909;c.
&#7902; 10 cho 20% thi&#7871;u ph&#7909;,t&#7915; nhi&#7877;m tr&#249;ng c&#7893; t&#7917; cung lan l&#234;n qua n&#7897;i m&#7841;c t&#7917; cung cho nhi&#7873;u &#7889;ng d&#7851;n tr&#7913;ng (vi&#234;m ph&#242;ng tr&#7913;ng) v&#224; ph&#250;c m&#7841;c v&#249;ng ch&#7853;u, ki&#7871;n thi&#7871;t d&#7883;ch vi&#234;m ti&#7875;u khung (PID). Chlamydiae ho&#7863;c vi khu&#7849;n &#273;&#432;&#7901;ng ru&#7897;t c&#361;ng c&#243; th&#7875; t&#7841;o PID. Vi&#234;m c&#7893; t&#7917; cung b&#7903;i l&#7853;u c&#7847;u th&#432;&#7901;ng &#273;i k&#232;m c&#243; tri&#7879;u ch&#7913;ng n&#7863;ng n&#7873; ti&#7875;u ho&#7863;c vi&#234;m &#7889;ng Skene & con &#273;&#432;&#7901;ng Bartholin. &#7902; 1 ph&#7847;n nh&#7887; tu&#7893;i &#273;&#7841;i tr&#432;&#7907;ng phu, vi&#234;m ni&#7879;u &#273;&#7841;o c&#243; th&#7875; ti&#7871;n tri&#7875;n cho vi&#234;m m&#224;o tinh ho&#224;n.
Nhi&#7877;m gonococcal lan to&#7843; (DGI) b&#7903;i s&#7921; l&#226;y lan trong m&#225;u th&#224;nh l&#7853;p < 1% tr&#432;&#7901;ng h&#7907;p, bao g&#7891;m &#7903; ph&#7909; n&#7919;. DGI th&#432;&#7901;ng &#7843;nh h&#432;&#7903;ng t&#225;c &#273;&#7897;ng mang &#273;&#7871;n domain authority, bao g&#226;n & kh&#7899;p. Vi&#234;m m&#224;ng kh&#244;ng t&#237;nh tim, vi&#234;m n&#7897;i ch&#7893; chi&#833;nh gi&#7919;a m&#7841;c, vi&#234;m m&#224;ng n&#227;o v&#224; vi&#234;m bao kh&#244;ng t&#237;nh gan hi&#7871;m khi x&#7843;y ra.
&#272;&#7891;ng nhi&#7877;m mang Chlamydia trachomatis x&#7843;y ra t&#7915; 15 mang &#273;&#7871;n 25% c&#225;nh m&#224;y r&#226;u b&#7883; d&#7883; t&#237;nh and 35 &#273;&#7871;n 1/2 ng&#432;&#7901;i v&#7907;.
[b]b&#7879;nh v&#224; bi&#7875;u l&#7897;[/b]
kho&#7843;ng 10 mang &#273;&#7871;n 20% ph&#225;i n&#7919; b&#7883; nhi&#7877;m & v&#244; c&#249;ng &#237;t &#273;&#7841;i tr&#432;&#7907;ng phu b&#7883; nhi&#7877;m ch&#432;a bao g&#7891;m b&#7879;nh. Kho&#7843;ng 25% nam gi&#7899;i bao g&#7891;m b&#7879;nh t&#7853;t t&#7889;i thi&#7875;u.
Vi&#234;m ni&#7879;u &#273;&#7841;o &#7903; nam g&#7891;m th&#7901;i k&#7923; &#7911; b&#7879;nh d&#7883;ch t&#7915; 2 mang &#273;&#7871;n 14 ng&#224;y. Kh&#7903;i ph&#225;t th&#432;&#7901;ng bao g&#7891;m bi&#7875;u l&#7897; c&#7843;m nh&#7853;n c&#259;ng th&#7859;ng &#7903; ni&#7879;u &#273;&#7841;o, ti&#7871;p theo l&#224; &#273;au v&#224; &#273;au nh&#7913;c d&#432;&#417;ng v&#7853;t n&#7863;ng h&#417;n, h&#7897;i ch&#7913;ng kh&#243; kh&#259;n ni&#7879;u & t&#232; m&#7911;. T&#7847;n su&#7845;t ti&#7871;t n&#432;&#7899;c &#273;&#225;i v&#224; t&#236;nh tr&#7841;ng nguy c&#7845;p c&#243; l&#7869; ti&#7871;n tri&#7875;n khi nhi&#7877;m tr&#249;ng l&#226;y lan mang &#273;&#7871;n ni&#7879;u &#273;&#7841;o sau. Kh&#225;m &#273;&#225;nh gi&#225; b&#7855;t g&#7863;p ra m&#7911; ni&#7879;u &#273;&#7841;o m&#224;u v&#224;ng-xanh, v&#224; l&#7895; ti&#7875;u v&#224; b&#7883; vi&#234;m.
[b]b&#7879;nh d&#7883;ch l&#7853;u (vi&#234;m ni&#7879;u &#273;&#7841;o)[/b]
Vi&#234;m m&#224;o tinh th&#432;&#7901;ng g&#226;y ra &#273;au b&#236;u solo, &#273;au, and s&#432;ng t&#7845;y. Hi&#7871;m khi, &#7903; &#273;&#7841;i tr&#432;&#7907;ng phu ti&#7871;n tri&#7875;n th&#224;nh ap xe c&#7911;a nh&#7919;ng tuy&#7871;n Tyson & Littre, &#225;p xe quanh ni&#7879;u &#273;&#7841;o, ho&#7863;c nhi&#7877;m tr&#249;ng tuy&#7871;n &#273;&#432;&#7901;ng Cowper, tuy&#7871;n &#273;&#432;&#7901;ng ti&#7873;n li&#7879;t, ho&#7863;c t&#250;i tinh.
Vi&#234;m c&#7893; t&#7917; cung th&#432;&#7901;ng c&#243; th&#7901;i k&#7923; &#7911; d&#7883;ch > 10 ng&#224;y. Bi&#7875;u hi&#7879;n t&#7915; nh&#7865; cho n&#7863;ng & bao g&#7891;m t&#7845;t c&#7843; n&#7863;ng n&#7873; ti&#7875;u ti&#7879;n & ra b&#7879;nh d&#7883;ch c&#417; quan sinh d&#7909;c n&#7919;. Trong c&#244;ng vi&#7879;c kh&#225;m v&#249;ng ch&#7853;u, BS l&#226;m s&#224;ng c&#243; l&#7869; c&#226;n nh&#7855;c nh&#7847;y m&#7911; c&#7893; t&#7917; cung ho&#7863;c n&#432;&#7899;c m&#7911;, v&#224; c&#7893; t&#7917; cung gi&#7889;ng nh&#432; &#273;&#432;&#7907;c m&#224;u &#273;&#7887; v&#224; b&#7883; ra m&#225;u m&#7897;t c&#225;ch d&#7877; d&#224;ng khi va b&#7857;ng lu&#7853;t ph&#225;p. Vi&#234;m ni&#7879;u &#273;&#7841;o c&#243; l&#7869; ph&#225;t tri&#7875;n ra &#273;&#7891;ng th&#7901;i; m&#7911; c&#243; th&#7875; ch&#7843;y ra t&#7915; ni&#7879;u &#273;&#7841;o khi &#233;p kh&#7899;p mu ho&#7863;c t&#7915; nhi&#7873;u &#7889;ng Skene ho&#7863;c tuy&#7871;n &#273;&#432;&#7901;ng Bartholin. Hi&#7871;m khi, nhi&#7877;m tr&#249;ng &#7903; tr&#7867; v&#224;y th&#224;nh ni&#234;n b&#7883; l&#7841;m d&#7909;ng t&#236;nh d&#7909;c ki&#7871;n t&#7841;o b&#7879;nh kh&#243; kh&#259;n t&#232;, ra m&#7911; &#226;m h&#7897; and k&#237;ch &#7913;ng &#226;m h&#7897;, &#273;&#7887; da v&#224; ph&#249;.
[b]b&#7879;nh l&#7853;u (Vi&#234;m &#226;m &#273;&#7841;o)[/b]
PID x&#7843;y ra trong 10 mang l&#7841;i 20% ph&#7909; n&#7919; b&#7883; nhi&#7877;m b&#7879;nh d&#7883;ch. PID c&#243; l&#7869; bao g&#7891;m vi&#234;m v&#242;i tr&#7913;ng, vi&#234;m ph&#250;c m&#7841;c v&#249;ng ch&#7853;u and &#225;p xe khung ch&#7853;u and c&#243; l&#7869; g&#226;y c&#7921;c nh&#7885;c ch&#7883;u &#273;&#7921;ng &#7903; b&#7909;ng d&#432;&#7899;i (th&#432;&#7901;ng l&#224; hai b&#234;n), &#273;au khi quan h&#7879;, v&#224; &#273;au khi th&#259;m kh&#225;m v&#249;ng b&#7909;ng, ph&#7847;n ph&#7909;, ho&#7863;c c&#7893; t&#7917; cung.
tri&#7879;u ch&#7913;ng Fitz-Hugh-Curtis d&#7883;ch vi&#234;m bao quanh gan gonococcal (ho&#7863;c chlamydia) x&#7843;y ra bao g&#7891;m &#7903; con g&#225;i and g&#226;y &#273;au h&#7841; s&#432;&#7901;n n&#234;n, s&#7889;t, bu&#7891;n n&#244;n m&#7917;a v&#224; n&#244;n m&#7917;a, th&#432;&#7901;ng gi&#7889;ng b&#7879;nh d&#7883;ch &#273;&#432;&#7901;ng m&#7853;t hay gan.
L&#7853;u c&#7847;u tr&#7921;c tr&#224;ng th&#432;&#7901;ng kh&#244;ng c&#243; tri&#7879;u ch&#7913;ng. N&#243; x&#7843;y ra bao g&#7891;m &#7903; c&#225;nh m&#224;y r&#226;u c&#243; quan h&#7879; t&#236;nh d&#7909;c &#273;&#7891;ng t&#237;nh ch&#224;o &#273;&#243;n and d&#432;&#7901;ng nh&#432; x&#7843;y ra &#7903; thanh n&#7919; ke&#833;o quan h&#7879; t&#236;nh d&#7909;c qua m&#7863;t &#273;&#432;&#7901;ng h&#7853;u m&#244;n. B&#7879;nh t&#7853;t bao g&#7891;m t&#7845;t c&#7843; ng&#7913;a tr&#7921;c tr&#224;ng, ra c&#259;n b&#7879;nh &#273;&#7909;c tr&#7921;c tr&#224;ng, ra m&#225;u, v&#224; t&#225;o khuy&#7871;t b&#243;n-t&#7845;t c&#7843; c&#225;c m&#7913;c &#273;&#7897; c&#7921;c k&#7923; nghi&#234;m tr&#7885;ng s&#225;ng t&#7887;. &#272;&#225;nh gi&#225; b&#7857;ng m&#225;y soi gi&#7889;ng nh&#432; b&#7855;t g&#7863;p th&#7845;y ban &#273;&#7887; ho&#7863;c nh&#7847;y m&#7911; b&#234;n tr&#234;n th&#224;nh tr&#7921;c tr&#224;ng.
Vi&#234;m h&#7885;ng b&#7903;i v&#236; l&#7853;u c&#7847;u th&#432;&#7901;ng kh&#244;ng b&#7879;nh nh&#432;ng l&#7841;i d&#432;&#7901;ng nh&#432; g&#226;y &#273;au h&#7885;ng. N. Gonorrhoeae n&#234;n &#273;&#432;&#7907;c kh&#225;c nhau c&#243; N. Meningitidis and nhi&#7873;u lo&#224;i v&#7853;t c&#243; &#7843;nh h&#432;&#7903;ng li&#234;n quan nghi&#234;m kh&#7855;c kh&#225;c th&#432;&#7901;ng th&#224;nh l&#7853;p c&#7893; h&#7885;ng m&#224; ch&#432;a g&#226;y b&#7879;nh ho&#7863;c g&#226;y h&#7841;i.
Nhi&#7877;m tr&#249;ng c&#7847;u khu&#7849;n lan t&#7887;a lan (DGI), c&#243; c&#225;ch g&#7885;i kh&#225;c l&#224; h&#7897;i ch&#7913;ng vi&#234;m s&#432;ng kh&#7899;p-vi&#234;m da, ph&#7843;n &#225;nh ho&#224;n c&#7843;nh nhi&#7877;m tr&#249;ng m&#225;u and th&#432;&#7901;ng tri&#7879;u ch&#7913;ng mang &#7889;m, &#273;au v&#7853;n &#273;&#7897;ng ho&#7863;c s&#432;ng kh&#7899;p (vi&#234;m &#273;a kh&#7899;p) & ch&#7845;n th&#432;&#417;ng nh&#7865; da b&#7883; m&#7909;n m&#7911;. &#7902; 1 s&#7889; &#237;t ng&#432;&#7901;i m&#7855;c b&#7879;nh, &#273;au ti&#7871;n tri&#7875;n v&#224; g&#226;n (v&#237; d&#7909;, &#7903; c&#7893; tay ho&#7863;c m&#7855;t c&#225; ch&#226;n) &#273;&#7887; ho&#7863;c s&#432;ng. C&#225;c t&#7893;n th&#432;&#417;ng domain authority th&#432;&#7901;ng x&#7843;y ra &#7903; c&#225;nh tay ho&#7863;c ch&#226;n, g&#7891;m n&#7873;n &#273;&#7887;, v&#224; nh&#7887;, h&#417;i &#273;au, & th&#432;&#7901;ng c&#243; m&#7909;n m&#7911;. L&#7853;u sinh d&#7909;c, ngu&#7891;n l&#226;y truy&#7873;n chung, ch&#7855;c l&#224; ch&#432;a c&#243; b&#7879;nh. DGI c&#243; v&#7867; h&#249;a theo nhi&#7873;u r&#7889;i lo&#7841;n kh&#225;c g&#226;y s&#7889;t, ch&#7845;n th&#432;&#417;ng nh&#7865; da, v&#224; vi&#234;m &#273;a kh&#7899;p (v&#237; d&#7909;, b&#7889;i c&#7843;nh vi&#234;m gan B ho&#7863;c m&#224;ng n&#227;o c&#7847;u); 1 s&#7889; nhi&#7873;u r&#7889;i lo&#7841;n kh&#225;c c&#361;ng x&#226;y d&#7921;ng tri&#7879;u ch&#7913;ng sinh d&#7909;c (v&#237; d&#7909;:, vi&#234;m kh&#7899;p ph&#7843;n &#7913;ng).
[b]L&#7853;u (t&#7893;n th&#432;&#417;ng da)[/b]
b&#7879;nh d&#7883;ch vi&#234;m kh&#7899;p v&#236; nhi&#7877;m l&#7853;u c&#7847;u l&#224; m&#7897;t d&#7841;ng DGI c&#7909;c b&#7897; h&#417;n d&#7851;n theo vi&#234;m kh&#7899;p &#273;au v&#7899;i tr&#224;n b&#7879;nh d&#7883;ch, th&#432;&#7901;ng l&#224; 1 ho&#7863;c 2 kh&#7899;p l&#7899;n nh&#432; &#273;&#7847;u g&#7889;i, m&#7855;t c&#225; ch&#226;n, c&#7893; tay, ho&#7863;c khu&#7927;u tay. 1 S&#7889; b&#7879;nh nh&#226;n t&#7845;t c&#7843; ho&#7863;c c&#243; ti&#7873;n s&#7917; t&#7893;n th&#432;&#417;ng domain authority c&#7911;a DGI. S&#7921; kh&#7903;i ph&#225;t th&#432;&#7901;ng si&#234;u c&#7845;p cho t&#237;nh, th&#432;&#7901;ng b&#7883; c&#7843;m c&#250;m, &#273;au kh&#7899;p d&#7919; d&#7897;i, and h&#7841;n ch&#7871; v&#7853;n &#273;&#7897;ng. Nhi&#7873;u kh&#7899;p b&#7883; nhi&#7877;m s&#432;ng l&#234;n, and domain authority ko k&#7875; ch&#7855;c l&#224; &#7845;m v&#224; &#273;&#7887;.
[b]Ch&#7849;n &#273;o&#225;n[/b]
[list]
	[*]Nhu&#7897;m Gram & gh&#233;p
	[*]X&#233;t nghi&#7879;m axit nucleic
[/list]
c&#259;n b&#7879;nh l&#7853;u &#273;&#432;&#7907;c ch&#7849;n &#273;o&#225;n khi d&#7883;ch giang ph&#7893;i &#273;&#432;&#7907;c b&#7855;t g&#7863;p th&#244;ng qua x&#233;t nghi&#7879;m b&#7903;i k&#237;nh hi&#7875;n vi h&#236;nh t&#432;&#7907;ng nhu&#7897;m Gram, nu&#244;i c&#7845;y, ho&#7863;c x&#233;t nghi&#7879;m nucleic acid b&#7879;nh sinh d&#7909;c, m&#225;u, ho&#7863;c h&#243;a h&#7885;c l&#7887;ng kh&#7899;p (thu &#273;&#432;&#7907;c b&#7903;i h&#250;t kim).
Nhu&#7897;m Gram l&#224; nh&#7841;y and s&#7879;t hi&#7879;u &#273;&#7889;i c&#243; d&#7883;ch l&#7853;u &#7903; ph&#225;i m&#7841;nh b&#7883; ra m&#7911; ni&#7879;u &#273;&#7841;o; c&#7847;u khu&#7849;n x&#7871;p &#273;&#244;i Gram &#226;m th&#432;&#7901;ng &#273;&#432;&#7907;c nh&#236;n th&#7845;y. Nhu&#7897;m Gram &#237;t &#273;&#250;ng &#273;&#7855;n h&#417;n &#273;&#7889;i s&#7903; h&#7919;u c&#7909;m tr&#432;&#7901;ng h&#7907;p nhi&#7877;m tr&#249;ng c&#7893; t&#7917; cung, h&#7885;ng and tr&#7921;c tr&#224;ng v&#224; c&#7843;m th&#7845;y kh&#244;ng &#273;&#432;&#7907;c l&#432;u &#253; &#273;&#7875; ch&#7849;n &#273;o&#225;n t&#7841;i c&#7909;m l&#227;nh th&#7893; n&#224;y.
c&#7845;y l&#224; nh&#7841;y c&#7843;m v&#224; &#273;&#7863;c hi&#7879;u, tuy th&#7871; b&#7903;i vi khu&#7849;n gonococci kh&#244;n c&#249;ng &#253; mu&#7889;n manh v&#224; c&#7841;nh tranh c&#7845;y, nhi&#7873;u m&#7851;u l&#7845;y b&#7903;i t&#259;m b&#244;ng c&#7847;n ph&#7843;i &#273;&#432;&#7907;c nhanh ch&#243;ng ph&#7871;t tr&#234;n kho&#7843;ng kh&#244;ng gian &#432;ng &#253; (th&#237; d&#7909; Thayer-Martin) & chuy&#234;n ch&#7903; &#273;&#7871;n ph&#242;ng th&#237; nghi&#7879;m b&#7857;ng nhi&#7873;u th&#249;ng v&#7853;n chuy&#7875;n bao g&#7891;m ch&#7913;a CO2. Bi&#7875;u t&#432;&#7907;ng m&#225;u and kh&#7899;p l&#7887;ng n&#234;n &#273;&#432;&#7907;c &#273;&#432;a mang l&#7841;i ph&#242;ng x&#233;t nghi&#7879;m mang b&#225;o hi&#7879;u r&#7857;ng nghi ng&#7901; nhi&#7877;m l&#7853;u c&#7847;u. V&#236; c&#225;c x&#233;t nghi&#7879;m khu&#7871;ch &#273;&#7841;i acid nucleic &#273;ang thay m&#7863;t nu&#244;i gh&#233;p trong &#273;&#7873;u c&#225;c ph&#242;ng th&#237; nghi&#7879;m, vi&#7879;c l&#7921;a t&#236;m m&#7897;t bu&#7891;ng th&#237; nghi&#7879;m c&#243; th&#7875; ph&#226;n ph&#7889;i vi&#7879;c x&#233;t nghi&#7879;m nu&#244;i c&#7845;y & &#273;&#7897; nh&#7841;y c&#7843;m c&#243; th&#7875; kh&#244;n c&#249;ng kh&#243; kh&#259;n & c&#7847;n &#273;&#432;&#7907;c t&#432; v&#7845;n v&#7899;i chuy&#234;n gia v&#7873; s&#7913;c kho&#7867; anh em ho&#7863;c chuy&#234;n gia v&#7873; c&#259;n b&#7879;nh truy&#7873;n nhi&#7877;m.
x&#233;t nghi&#7879;m khu&#7871;ch &#273;&#7841;i acid nucleic (NAATs) c&#243; th&#7875; &#273;&#432;&#7907;c &#225;p d&#7909;ng tr&#234;n b&#7879;nh sinh d&#7909;c, tr&#7921;c tr&#224;ng ho&#7863;c mi&#7879;ng. H&#7891; h&#7871;t nhi&#7873;u x&#233;t nghi&#7879;m c&#249;ng l&#250;c b&#7855;t g&#7863;p b&#7879;nh d&#7883;ch l&#7853;u v&#224; nhi&#7877;m chlamydia and sau &#7845;y ri&#234;ng bi&#7879;t gi&#7919;a ch&#250;ng trong 1 x&#233;t nghi&#7879;m chi ti&#7871;t ti&#7871;p theo. NAATs t&#259;ng t&#7889;c &#273;&#7897; nh&#7841;y c&#7843;m cho x&#233;t nghi&#7879;m bi&#7875;u t&#432;&#7907;ng n&#432;&#7899;c &#273;&#225;i &#7903; c&#7843; hai gi&#7899;i.
T&#7841;i Hoa K&#7923;, ph&#7843;i b&#225;o c&#225;o c&#7909;m tr&#432;&#7901;ng h&#7907;p b&#7879;nh l&#7853;u, nhi&#7877;m chlamydia & giang mai mang l&#7841;i h&#7879; th&#7889;ng y t&#7871; ch&#7895; &#273;&#244;ng ng&#432;&#7901;i. C&#225;c x&#233;t nghi&#7879;m huy&#7871;t thanh h&#7885;c mang l&#7841;i c&#259;n b&#7879;nh giang mai (STS) and HIV and NAAT &#273;&#7875; ch&#7885;n l&#7885;c nhi&#7877;m chlamydia c&#361;ng n&#234;n &#273;&#432;&#7907;c &#225;p d&#7909;ng.
[b]&#273;&#224;n &#244;ng b&#7883; vi&#234;m ni&#7879;u &#273;&#7841;o[/b]
ph&#225;i m&#7841;nh b&#7883; r&#242; r&#7881; r&#245; r&#7879;t c&#243; th&#7875; &#273;&#432;&#7907;c ch&#7919;a b&#7879;nh 1 c&#225;ch gi&#7843; t&#7841;o n&#234;n n&#7871;u c&#243; t&#225;c d&#7909;ng k&#233;o d&#224;i theo d&#245;i ho&#7863;c n&#7871;u c&#225;c kh&#237; c&#7909; ch&#7849;n &#273;o&#225;n d&#7921;a v&#224;o b&#7879;nh vi&#7879;n kh&#244;ng c&#243; s&#7861;n.
nhi&#7873;u h&#236;nh m&#7851;u &#273;&#7875; nhu&#7897;m Gram gi&#7889;ng nh&#432; s&#7903; h&#7919;u &#273;&#432;&#7907;c b&#7857;ng ph&#432;&#417;ng ph&#225;p va v&#224;o m&#7897;t m&#7851;u t&#259;m ho&#7863;c tr&#432;&#7907;t k&#7871;t th&#250;c sinh d&#7909;c nam &#273;&#7875; l&#7845;y h&#243;a h&#7885;c th&#7843;i. Nhu&#7897;m Gram kh&#244;ng th&#7887;a thu&#7853;n &#273;&#432;&#7907;c Chlamydiae, b&#7903;i th&#7871; c&#243; v&#7867; l&#7845;y h&#236;nh m&#7851;u n&#432;&#7899;c &#273;&#225;i ho&#7863;c SWAB cho NAAT.
[b]ch&#7883; em c&#243; tri&#7879;u ch&#7913;ng ho&#7863;c d&#7845;u hi&#7879;u sinh d&#7909;c[/b]
1 h&#236;nh m&#7851;u ngo&#225;y b&#7879;nh d&#7883;ch c&#7893; t&#7917; cung y&#234;u c&#7847;u &#273;&#432;&#7907;c &#273;&#432;a nu&#244;i c&#7845;y ho&#7863;c NAAT. N&#7871;u quan y&#7871;u &#273;&#225;nh gi&#225; khung ch&#7853;u, NAAT c&#7911;a m&#7851;u n&#432;&#7899;c &#273;&#225;i ho&#7863;c t&#259;m b&#244;ng &#226;m h&#7897; t&#7921; thu th&#7853;p &#273;&#432;&#7907;c ch&#7855;c l&#224; ph&#225;t hi&#7879;n d&#7883;ch nhi&#7877;m l&#7853;u c&#7847;u (v&#224; chlamydia) c&#225;ch nhanh nh&#7845;t ch&#243;ng v&#224; an to&#224;n v&#224; tin c&#7853;y.
[b]Ph&#417;i nhi&#7877;m h&#7885;ng ho&#7863;c tr&#7921;c tr&#224;ng (c&#7843; hai gi&#7899;i t&#237;nh)[/b]
Ngo&#225;y d&#7883;ch c&#7911;a ch&#7889;n b&#7883; &#7843;nh h&#432;&#7903;ng t&#225;c &#273;&#7897;ng &#273;&#432;&#7907;c g&#7917;i mang &#273;&#7871;n v&#259;n ho&#225; ho&#7863;c NAAT.
[b]Vi&#234;m kh&#7899;p, DGI, ho&#7863;c c&#7843; hai[/b]
1 kh&#7899;p b&#7883; t&#225;c &#273;&#7897;ng c&#7847;n &#273;&#432;&#7907;c d&#7851;n l&#432;u, & b&#7879;nh d&#7883;ch kh&#7899;p bu&#7897;c ph&#7843;i &#273;&#432;&#7907;c g&#7917;i nu&#244;i c&#7845;y v&#224; ph&#226;n t&#237;ch chuy&#234;n nghi&#7879;p (d&#7851;n l&#432;u b&#7879;nh d&#7883;ch kh&#7899;p). Ng&#432;&#7901;i b&#7883; b&#7879;nh b&#7883; ch&#7845;n th&#432;&#417;ng nh&#7865; da, b&#7879;nh to&#224;n th&#226;n, ho&#7863;c c&#7843; hai b&#7855;t bu&#7897;c c&#243; nu&#244;i gh&#233;p m&#225;u, ni&#7879;u &#273;&#7841;o, c&#7893; t&#7917; cung v&#224; tr&#7921;c tr&#224;ng ho&#7863;c NAAT. Trong ch&#7863;ng 30 mang &#273;&#7871;n 40% b&#7879;nh nh&#226;n s&#7903; h&#7919;u DGI, gh&#233;p m&#225;u d&#432;&#417;ng t&#237;nh trong tu&#7847;n b&#432;&#7899;c &#273;&#7847;u ti&#234;n c&#7911;a b&#7879;nh. V&#7899;i c&#259;n b&#7879;nh vi&#234;m kh&#7899;p l&#7853;u c&#7847;u, nu&#244;i c&#7845;y m&#225;u th&#432;&#7901;ng &#237;t d&#432;&#417;ng th&#7871;, m&#224; l&#7841;i nu&#244;i gh&#233;p b&#7879;nh d&#7883;ch kh&#7899;p l&#224; c&#245;i d&#432;&#417;ng tr&#7847;n. D&#7883;ch kh&#7899;p th&#432;&#7901;ng &#273;&#7909;c &#273;&#7871;n m&#7911; v&#236; s&#7889; l&#432;&#7907;ng Kh&#7911;ng WBCs (th&#432;&#7901;ng > &#273;&#244;i m&#432;&#417;i,000/μL).
[b]l&#7921;a ch&#7885;n[/b]
c&#225;c ng&#432;&#7901;i b&#7879;nh kh&#244;ng bao g&#7891;m b&#7879;nh &#273;&#432;&#7907;c c&#243; c&#7843;nh nguy hi&#7875;m cao b&#7883; b&#7879;nh l&#226;y truy&#7873;n qua m&#7863;t &#273;&#432;&#7901;ng t&#236;nh d&#7909;c (STDs) d&#432;&#7901;ng nh&#432; &#273;&#432;&#7907;c ch&#7885;n l&#7885;c b&#7857;ng NAAT c&#7909;m h&#236;nh m&#7851;u n&#432;&#7899;c t&#232;, Nh&#432; v&#7853;y kh&#244;ng c&#7847;n ph&#432;&#417;ng th&#7913;c x&#226;m l&#7845;n &#273;&#7875; l&#7845;y h&#236;nh m&#7851;u t&#7915; nh&#7919;ng &#273;&#417;n v&#7883; sinh d&#7909;c.
&#273;&#224;n b&#224; ch&#432;a c&#243; b&#7847;u (bao g&#7891;m c&#7843; nh&#7919;ng thi&#7871;u ph&#7909; c&#243; quan h&#7879; t&#236;nh d&#7909;c c&#243; ph&#7909; n&#7919;) &#273;&#432;&#7907;c ch&#7855;t l&#7885;c h&#224;ng n&#259;m n&#7871;u ch&#250;ng ta
[list]
	[*]c&#243; v&#7853;n &#273;&#7897;ng t&#236;nh d&#7909;c and &#8804; 24 tu&#7893;i
	[*]bao g&#7891;m ti&#7873;n s&#7917; m&#7855;c b&#7879;nh STD
	[*]d&#7921; va&#832;o v&#224;o h&#224;nh vi t&#236;nh d&#7909;c t&#7845;t c&#7843; c&#7843;nh hi&#7875;m nghe&#832;o cao (v&#237; d&#7909;: t&#7845;t c&#7843; ng&#432;&#7901;i t&#236;nh b&#7855;t &#273;&#7847;u ho&#7863;c nhi&#7873;u b&#7841;n t&#236;nh, gia nh&#7853;p v&#224;o m&#7841;i d&#226;m, th&#7921;c hi&#7879;n BCS ch&#432;a th&#432;&#7901;ng xuy&#234;n)
	[*]c&#243; m&#7897;t th&#224;nh vi&#234;n t&#236;nh ke&#833;o v&#224;o h&#224;nh vi t&#7845;t c&#7843; nguy c&#417; cao
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n&#7919; gi&#7899;i c&#243; b&#7847;u &#273;&#432;&#7907;c kh&#225;m nghi&#7879;m trong l&#7847;n kh&#225;m b&#7847;u b&#432;&#7899;c &#273;&#7847;u ti&#234;n c&#7911;a h&#7885; v&#224; m&#7897;t l&#7847;n n&#7919;a trong 3 th&#225;ng cu&#7889;i n&#7871;u h&#7885; &#8804; 24 tu&#7893;i ho&#7863;c c&#243; nh&#7919;ng kh&#237;a c&#7841;nh c&#7843;nh hi&#7875;m nghe&#832;o.
nh&#224; b&#7841;n &#273;&#7841;i tr&#432;&#7907;ng phu chuy&#7875;n &#273;&#7897;ng t&#236;nh d&#7909;c kh&#225;c gi&#7899;i c&#7843;m th&#7845;y kh&#244;ng &#273;&#432;&#7907;c kh&#225;m nghi&#7879;m th&#7901;i h&#7841;n tr&#7915; khi h&#7885; c&#242;n l&#224; g&#7891;m c&#7843;nh hi&#7875;m nghe&#832;o cao (v&#237; d&#7909; nh&#432; ph&#7847;n &#273;a c&#225;c b&#7841;n bao g&#7891;m quan h&#7879; t&#236;nh d&#7909;c &#273;&#7891;ng gi&#7899;i, ng&#432;&#7901;i m&#7855;c b&#7879;nh &#7903; b&#7879;nh vi&#7879;n thanh thi&#7871;u ni&#234;n ho&#7863;c STD, nam nhi v&#224;o nhi&#7873;u c&#225;c &#273;&#7841;i l&#253; c&#7843;i hu&#7845;n).
Nam quan h&#7879; t&#236;nh d&#7909;c &#273;&#7891;ng gi&#7899;i &#273;&#432;&#7907;c kh&#225;m nghi&#7879;m n&#7871;u h&#7885; &#273;&#227; c&#243; chuy&#7875;n &#273;&#7897;ng t&#236;nh d&#7909;c trong n&#259;m tr&#432;&#7899;c (&#273;&#7889;i v&#7899;i ng&#432;&#7901;i trong gia &#273;&#236;nh mang &#273;&#7871;n, ch&#7855;t l&#7885;c n&#432;&#7899;c t&#232;, s&#7903; h&#7919;u giao h&#7907;p &#273;&#243;n nh&#7853;n, ngo&#225;y tr&#7921;c tr&#224;ng & &#273;&#7871;n b&#224;n giao h&#7907;p b&#7857;ng mi&#7879;ng, ngo&#225;y h&#7885;ng).
(Xem b&#7893; sung share c&#7909;m khuy&#7871;n ngh&#7883; c&#7911;a nh&#243;m bu&#244;n b&#225;n ph&#242;ng ng&#7915;a Hoa K&#7923; screening for gonorrhea.)
[b]&#273;i&#7873;u tr&#7883;[/b]
[list]
	[*]&#272;&#7889;i v&#7899;i nhi&#7877;m tr&#249;ng ch&#432;a bi&#7871;n ch&#7913;ng, m&#7897;t li&#7873;u duy nh&#7845;t ceftriaxone c&#7897;ng s&#7903; h&#7919;u azithromycin
	[*]&#272;&#7889;i v&#7899;i DGI b&#7883; vi&#234;m kh&#7899;p, m&#7897;t &#273;&#7907;t kh&#225;ng sinh &#273;&#432;&#7901;ng u&#7889;ng d&#224;i ra h&#417;n
	[*]&#273;i&#7873;u tr&#7883; &#273;&#7891;ng nhi&#7877;m Chlamydia
	[*]&#273;i&#7873;u tr&#7883; ng&#432;&#7901;i t&#236;nh
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Nhi&#7877;m tr&#249;ng l&#7853;u c&#7847;u c&#7893; t&#7917; cung, tr&#7921;c tr&#224;ng and h&#7885;ng ch&#432;a bi&#7871;n ch&#7913;ng &#273;&#432;&#7907;c ch&#7919;a b&#7879;nh nh&#432; sau:
[list]
	[*]&#431;u ti&#234;n: duy nh&#7845;t 1 li&#7873;u ch&#7881; m&#7897;t c&#7911;a ceftriaxone 250 mg b&#7855;p th&#7883;t c&#249;ng c&#243; azithromycin 1 g u&#7889;ng 1 l&#7847;n (thay v&#7855;t mang l&#7841;i azithromycin l&#224; doxycycline 100 mg po hai l&#7847;n m&#7897;t ng&#224;y trong 7 ng&#224;y)
	[*]ch&#7885;n l&#7885;c th&#7913; hai: m&#7897;t li&#7873;u ch&#7881; m&#7897;t c&#7911;a cefixime 400 mg u&#7889;ng c&#249;ng v&#7899;i azithromycin m&#7897;t g u&#7889;ng 1 l&#7847;n
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b&#7879;nh nh&#226;n b&#7883; d&#7883; &#7913;ng v&#7899;i cephalosporin, &#273;&#432;&#7907;c &#273;i&#7873;u tr&#7883; b&#7903;i 1 trong c&#225;c thu&#7889;c sau:
[list]
	[*]Gemifloxacin 320 mg u&#7889;ng c&#249;ng s&#7903; h&#7919;u azithromycin 2 g u&#7889;ng
	[*]Gentamicin 240 mg b&#7855;p th&#7883;t c&#249;ng v&#7899;i azithromycin 2 g u&#7889;ng
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gi&#7843;i ph&#225;p &#273;&#7889;i ch&#7885;i tr&#7883; & c&#225;c thu&#7889;c fluoroquinolones u&#7889;ng (v&#237; d&#7909;, ciprofloxacin, levofloxacin, ofloxacin) ho&#7863;c cefixime kh&#244;ng c&#242;n &#273;&#432;&#7907;c khuy&#7871;n c&#225;o b&#7903;i v&#236; s&#7921; c&#7911;ng c&#7889; kh&#225;ng thu&#7889;c. Ki&#7875;m tra ch&#7919;a kh&#7887;i b&#7879;nh ch&#7881; &#273;&#432;&#7907;c Note &#273;&#7889;i mang b&#7879;nh nh&#226;n &#273;&#432;&#7907;c ch&#7919;a b&#7879;nh b&#7857;ng ph&#225;c &#273;&#7891; t&#432;&#7907;ng tr&#432;ng cho nhi&#7877;m tr&#249;ng h&#7885;ng.
DGI s&#7903; h&#7919;u c&#259;n b&#7879;nh vi&#234;m kh&#7899;p gonococcal thu&#7903; &#273;&#7847;u &#273;&#432;&#7907;c ch&#7919;a b&#7879;nh b&#7857;ng ch&#7845;t kh&#225;ng sinh IM ho&#7863;c IV (v&#237; d&#7909;, ceftriaxone m&#7897;t g b&#7855;p th&#7883;t ho&#7863;c th&#297;nh m&#7841;ch m&#7895;i 24 gi&#7901;, ceftizoxime 1 g t&#297;nh m&#7841;ch m&#7895;i 8 gi&#7901;, cefotaxime m&#7897;t g t&#297;nh m&#7841;ch m&#7895;i 8 gi&#7901;) &#273;&#7913;ng v&#7919;ng trong 24 &#273;&#7871;n 48 gi&#7901; m&#7897;t khi b&#7879;nh t&#7853;t b&#7899;t, ti&#7871;p theo l&#224; 4 mang &#273;&#7871;n 7 ng&#224;y &#273;i&#7873;u tr&#7883; thu&#7889;c u&#7889;ng. Thu&#7889;c kh&#225;ng chlamydia c&#361;ng th&#432;&#7901;ng &#273;&#432;&#7907;c c&#226;&#768;n d&#249;ng.
c&#259;n b&#7879;nh vi&#234;m kh&#7899;p l&#7853;u c&#7847;u th&#432;&#7901;ng ch&#432;a c&#7847;n thi&#7871;t &#273;&#7873; ngh&#7883; d&#7851;n l&#432;u b&#7879;nh kh&#7899;p. Kh&#7903;i &#273;&#226;&#768;u, kh&#7899;p l&#224; c&#7889; &#273;&#7883;nh &#7903; m&#7897;t v&#7883; th&#7871; h&#224;o ki&#7879;t. Nhi&#7873;u b&#224;i x&#237;ch t&#7853;p r&#432;&#7907;u c&#7891;n b&#7883; &#273;&#7897;ng th&#7909; r&#432;&#7907;u c&#7891;n y&#234;u c&#7847;u &#273;&#432;&#7907;c ban &#273;&#7847;u ngay khi b&#7879;nh nh&#226;n h&#236;nh nh&#432; ch&#7883;u &#273;&#7921;ng &#273;&#432;&#7907;c. Sau khi gi&#7843;m &#273;au, &#273;&#7873; xu&#7845;t b&#7847;y &#273;&#224;n d&#7909;c m&#224; c&#242;n, ti&#7871;p t&#7909;c and t&#259;ng t&#7889;c c&#417; b&#7855;p. Tr&#234;n 95% ng&#432;&#7901;i m&#7855;c b&#7879;nh &#273;i&#7873;u tr&#7883; c&#259;n b&#7879;nh vi&#234;m kh&#7899;p v&#236; ch&#432;ng b&#7879;nh d&#7883;ch gonococcal ph&#7909;c h&#7891;i thi&#234;n t&#224;i kh&#7899;p ho&#224;n ch&#7881;nh. V&#236; s&#7921; t&#237;ch t&#7909; b&#7879;nh d&#7883;ch kh&#7899;p v&#244; tr&#249;ng (tr&#224;n b&#7879;nh kh&#7899;p) c&#243; v&#7867; l&#224;m ti&#7871;p trong th&#7901;i gian nhi&#7873;u n&#259;m, thu&#7889;c ch&#7889;ng vi&#234;m c&#243; l&#7869; b&#7893; &#237;ch.
c&#7845;y khu&#7849;n sau ch&#7919;a tr&#7883; l&#224; ch&#432;a c&#7847;n ph&#7843;i c&#243; n&#7871;u cung c&#7845;p b&#7879;nh t&#7853;t l&#224; nh&#7919;ng. B&#234;n c&#7841;nh &#273;&#243;, &#273;&#7889;i c&#243; b&#7879;nh nh&#226;n g&#7891;m tri&#7879;u ch&#7913;ng > 7 ng&#224;y, bu&#7897;c ph&#7843;i l&#7845;y h&#236;nh t&#432;&#7907;ng, nu&#244;i c&#7845;y, v&#224; ki&#7875;m so&#225;t &#273;&#7897; nh&#7841;y c&#7843;m c&#7911;a kh&#225;ng sinh.
b&#7879;nh nh&#226;n bu&#7897;c ph&#7843;i ki&#234;ng ho&#7841;t &#273;&#7897;ng t&#236;nh d&#7909;c cho t&#7899;i l&#250;c ch&#7919;a tr&#7883; &#273;&#432;&#7907;c ch&#7845;m d&#7913;t &#273;&#7875; tr&#225;nh l&#226;y nhi&#7877;m cho ch&#237;nh m&#236;nh t&#236;nh.
[b]&#272;&#7885;c th&#234;m v&#7873; b&#7879;nh l&#7853;u[/b]
[list]
	[*][url=https://hoiluatgia.hatinh.gov.vn/upload/tailieu/benh-lau-la-gi-chi-phi-chua-benh-lau-bao-nhieu-tie-1632469549n.htm]c&#225;ch ch&#7919;a b&#7879;nh l&#7853;u[/url]
	[*][url=https://hoiluatgia.hatinh.gov.vn/upload/tailieu/cach-chua-benh-lau-nhanh-hoi-phu-1632469821c.htm]benh lau[/url]
	[*][url=https://uni.lut.fi/vi/web/bsthaiha/home/-/blogs/chi-phi-chua-benh-lau-het-bao-nhieu-tien-co-dat-khong]ch&#7919;a b&#7879;nh l&#7853;u h&#7871;t bao nhi&#234;u ti&#7873;n[/url]
	[*][url=http://wiedza.imp.lodz.pl/web/bacsituvan247/home/-/blogs/benh-lau-nguyen-nhan-do-%C4%91au-tu-van-xet-nghiem-benh-lau]b&#7879;nh l&#7853;u l&#224; g&#236;[/url]
	[*][url=http://benhvienlaovabenhphoicantho.vn/Default.aspx?tabid=120&ch=3186]b&#7879;nh l&#7853;u[/url]
	[*][url=http://benhvienlaovabenhphoicantho.vn/Default.aspx?tabid=120&ch=3189]c&#225;ch &#273;i&#7873;u tr&#7883; b&#7879;nh l&#7853;u[/url]
	[*][url=http://bvtimmachcantho.vn/Default.aspx?tabid=120&ch=2678]benh lau[/url]
	[*][url=https://www.jsm.gov.my/vi/web/visuckhoecongdong/home/-/blogs/benh-lau-de-lau-co-sao-khong-chua-benh-lau-o-dau-ha-noi-]benh lau[/url]
	[*][url=http://doanhnghiephatinh.vn/upload/tailieu/chi-phi-chua-benh-lau-bao-nhieu-tien-chi-tu-5-000-000-vn-1636700948d.htm]b&#7879;nh l&#7853;u l&#224; g&#236;[/url]
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[b]&#272;&#7885;c th&#234;m v&#7873; b&#7879;nh s&#249;i m&#224;o g&#224;[/b]
[list]
	[*][url=https://hoiluatgia.hatinh.gov.vn/upload/tailieu/chi-phi-chua-benh-sui-mao-ga-bao-nhieu-tie-1632470439n.htm]&#273;&#7889;t s&#249;i m&#224;o g&#224;[/url]
	[*][url=https://hoiluatgia.hatinh.gov.vn/upload/tailieu/dia-chi-chua-sui-mao-ga-o-dau-tot-nha-1632471113t.htm]ph&#242;ng kh&#225;m s&#249;i m&#224;o g&#224;[/url]
	[*][url=https://uni.lut.fi/vi/web/bsthaiha/home/-/blogs/top-5-dia-chi-chua-sui-mao-ga-uy-tin-o-ha-noi]ch&#7919;a b&#7879;nh s&#249;i m&#224;o g&#224; &#7903; &#273;&#226;u t&#7889;t[/url]
	[*][url=http://benhvienlaovabenhphoicantho.vn/Default.aspx?tabid=120&ch=3157]chi ph&#237; ch&#7919;a s&#249;i m&#224;o g&#224;[/url]
	[*][url=http://benhvienlaovabenhphoicantho.vn/Default.aspx?tabid=120&ch=3194]benh sui mao ga[/url]
	[*][url=http://bvtimmachcantho.vn/Default.aspx?tabid=120&ch=2662]ch&#7919;a s&#249;i m&#224;o g&#224; &#7903; &#273;&#226;u t&#7889;t[/url]
	[*][url=http://benhvienlaovabenhphoicantho.vn/Default.aspx?tabid=120&ch=5475]chi ph&#237; &#273;i&#7873;u tr&#7883; b&#7879;nh s&#249;i m&#224;o g&#224;[/url]
	[*][url=https://www.jsm.gov.my/vi/web/visuckhoecongdong/home/-/blogs/cac-cach-chua-va-dieu-tri-sui-mao-ga-ban-nen-biet]&#273;i&#7873;u tr&#7883; s&#249;i m&#224;o g&#224;[/url]
	[*][url=https://www.jsm.gov.my/vi/web/visuckhoecongdong/home/-/blogs/cac-cach-chua-benh-sui-mao-ga-hieu-qua-nhat]ch&#7919;a b&#7879;nh s&#249;i m&#224;o g&#224;[/url]
	[*][url=http://trungtamytehoavang.com.vn/question/6-cach-dieu-tri-sui-mao-ga-hieu-qua-duoc-ap-dung-hien-nay/]tr&#7883; s&#249;i m&#224;o g&#224;[/url]
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[b]&#272;&#7885;c th&#234;m v&#7873; b&#7879;nh giang mai[/b]
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	[*][url=https://hoiluatgia.hatinh.gov.vn/upload/tailieu/cach-dieu-tri-giang-mai-giai-doan-dau-nhanh-hoi-phu-1632469997c.htm]ch&#7919;a b&#7879;nh giang mai[/url]
	[*][url=http://bvtimmachcantho.vn/Default.aspx?tabid=120&ch=2690]&#273;i&#7873;u tr&#7883; giang mai giai &#273;o&#7841;n 2[/url]
	[*][url=http://ytephunghiep.vn/Default.aspx?tabid=120&ch=2928]c&#225;ch ch&#7919;a b&#7879;nh giang mai[/url]
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&#272;&#7885;c th&#234;m v&#7873; b&#7879;nh x&#227; h&#7897;i
[list]
	[*][url=http://bvtimmachcantho.vn/Default.aspx?tabid=120&ch=2936]x&#233;t nghi&#7879;m b&#7879;nh x&#227; h&#7897;i &#7903; &#273;&#226;u[/url]
	[*][url=http://benhvienlaovabenhphoicantho.vn/Default.aspx?tabid=120&ch=3199]kh&#225;m b&#7879;nh x&#227; h&#7897;i &#7903; &#273;&#226;u[/url]
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