Gram Negative Cocci - Neisseria/Moraxella

Question 1

Clinical presentations of N. meningitidis? (+Clinical indications)

Answer 1

1. Meningococcaemia
2. Fulminant Meningococcaemia with septic shock
3. Meningitis
   Clinical signs: Haemorrhagic lesions and Tumbler test for blanching skin

Question 2

Clinical presentations of N. gonorrhoeae?

Answer 2

1. Gonorrhoea
   - Urethritis with discharge and dysuria
   - Conjunctivitis
   - Proctitis (spread to rectum)
   - Ascending infections in females eg. Fitz-Hugh-Curtis syndrome in liver
2. URTIs
3. OPHTHALMIC NEONATARUM

Question 3

Neisseria is a Gram ___ Diplococci and is Oxidase ___

Answer 3

Negative, Positive

Question 4

Virulence factors of N. meningitidis

Answer 4

Endotoxin (Lipo-oligosaccharide)
Capsule - A, B, C, W135 subgroups

Question 5

Virulence factors of N. gonorrhoea

Answer 5

Endotoxins (LOS), fimbriae and OMPs (with antigenic variation and varied expression)

Question 6

Does N. gonorrhoea have immunological memory?

Answer 6

No, possibility of repeated infections

Question 7

How does N. meningitidis spread?

Answer 7

Close contact or respiratory droplets

Question 8

How does N. gonorrhoea spread?

Answer 8

Sexual contact or fomites

Question 9

How is N. meningitidis treated and prevented?

Answer 9

Benzylpenicillin (Penicillin G)
Ceftriaxone to clear carriage
Conjugated vaccine if travelling to Meningitis belt

Question 10

How is N. gonorrhoea treated?

Answer 10

IM ceftriaxone + Oral azithromycin

Question 11

Clinical presentations of Moraxella?

Answer 11

Opportunistic infections of URTs

Question 12

Treatment for Moraxella?

Answer 12

Coamoxiclav (Augmentin - Amoxicillin and Clavulanic acid)

Question 13

How is N. gonorrhoea diagnosed in males?

Answer 13

Gram stain from urethral, throat, rectum samples

Question 14

How is N. gonorrhoea diagnosed in females?

Answer 14

Culture from endocervical, throat, rectal samples

Question 15

M. catarrhalis causes ___
M. lacunata causes ___

Answer 15

Opportunistic bronchopneumonia (COPD, immunocompromised patients)
Blepharoconjunctivitis

Question 16

Against which Group of N. meningitidis is there no routine vaccination and why?

Answer 16

Group B
Antigen is similar to normal human tissue and may cause an autoimmune reaction

Question 17

Is Neisseria gonorrhoeae part of normal flora?

Answer 17

No, it is an STD

Question 18

How to prevent N. gonorrhoeae?

Answer 18

Condoms and safe sex, silver nitrate eye drops (antibiotics)