Microbiology
Summary
Neisseria gonorrhoeae, a gram-negative diplococcus, is the causative agent of the sexually transmitted infection, gonorrhea. N. gonorrhoeae is not encapsulated and can develop in asymptomatic carriers. It can infect genitalia, with symptoms ranging from urethritis, prostatitis, and epididymitis in male individuals to urethritis, cervicitis, pelvic inflammatory disease (PID), and salpingitis in those with female reproductive organs. The infection can also affect newborns through direct contact during labor and delivery, potentially leading to a severe eye infection and blindness.
Diagnosis involves gram staining and culturing of urine, urethral, or endocervical specimens, with nucleic acid amplification testing (NAAT) being the test of choice due to its high sensitivity and rapid results. Treatment includes a single intramuscular dose of ceftriaxone, along with either doxycycline or a macrolide like azithromycin to cover potential chlamydia co-infection. Since Neisseria gonorrhoeae can cause recurrent infections, prevention methods such as consistent condom use are essential.
Lesson Outline
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FAQs
N. gonorrhoeae is the causative agent for several infections which include urethritis, prostatitis, cervicitis, pelvic inflammatory disease (PID), ophthalmia neonatorum (a form of conjunctivitis that occurs in newborns), Fitz-Hugh-Curtis syndrome (adhesions between the liver and the diaphragm, often associated with PID), and disseminated gonococcal infection.
N. gonorrhoeae is a gram-negative diplococcus, which means the spherical bacteria remain joined together after cell division. It is also a facultative intracellular organism, allowing it to invade and survive within host cells, which contributes to its ability to evade the host immune system and establish infections in various body tissues.
N. gonorrhoeae is one of the main causative agents for pelvic inflammatory disease (PID), a condition involving the inflammation of female reproductive organs such as the uterus, fallopian tubes, and ovaries. When N. gonorrhoeae infects the cervix, it can ascend into the upper genital tract and lead to PID. This infection can cause serious complications like chronic pelvic pain, ectopic pregnancy, and infertility.
Disseminated gonococcal infection (DGI) occurs when N. gonorrhoeae spreads through the bloodstream to other parts of the body. DGI commonly presents as a triad of symptoms: arthritis, tenosynovitis (inflammation of a tendon sheath), and dermatitis (skin rash). Complications can arise if DGI is left untreated, potentially causing septic arthritis, endocarditis, and meningitis.
A common infection N. gonorrhoeae causes in newborns is ophthalmia neonatorum Ñ a severe eye infection that can lead to blindness if left untreated. This infection occurs when a baby is exposed to the bacteria during vaginal delivery from an infected mother. To prevent ophthalmia neonatorum, all newborns should receive prophylactic eye treatment, such as erythromycin ointment, as part of their standard post-delivery care.
