Neisseria gonorrhoeae Flashcards

1
Q

what is the biology of Neisseria gonorrhoeae?

A

Gram negative diplococcus (kidney-shaped cocci) *

Oxidase +

catalase + *

Breaks down only Glucose (Gonococcus) *

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2
Q

where do we find a reservoir of N. gonorrhoeae in the body?

A

Human genital tract (asymptomatic infected individuals)*

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3
Q

how does it spread?

A

Sexual contact

Neonates – during birth

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4
Q

what disease does neisseria gonorrhoeae cause?

A
  • Causes Gonorrhoea – a sexually transmitted disease (STD)
  • Rectal infections *
  • Pharyngitis *
  • Ophthalmia neonatorum *(neonatal conjunctivitis)
  • Disseminated infection
  • Septic arthritis *
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5
Q

what are Gonococcus’s Virulence factors *?

A

Pili

Outer membrane proteins

IgA protease

Lipooligosaccharide (LOS) *

Antigenic and Phase variation *

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6
Q

what will the pili help do?

A

adherence and colonization *

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7
Q

besides the pili, what other virulence factor is important for colonization?

A

IgA protease

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8
Q

what is Antigenic and Phase variation *?

A
  • antigenic variation = the ability to express numerous different pili
  • The aminoacid sequences of the pili vary, therefore the pili are antigenically distinct
  • During an infection Gonococcus can evade detection by the hosts’ immune system by changing the pili it expresses
  • phase variation = turning on or off the production of pili
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9
Q

Antigenic variation occurs with what virulence factors?

A

Pili

Outer membrane proteins

LOS (Lipooligosaccharide)

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10
Q

Antigenic variation accounts for what?

A

chronicity of infections *

lack of protection against subsequent gonococcal infections

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11
Q

what is gonorrhea?

A
  • mucous membrane infection
  • the site of infection is dependent on type of sexual contact & sexual practices
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12
Q

who transmits the disease?

A

Both asymptomatic and symptomatic persons

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13
Q

what will untreated and repeated infections cause?

A
  • cause scarring
  • May lead to infertility in both sexes
  • may predispose women to ectopic pregnancy
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14
Q

what Genito-urinary tract infection will be caused in men?

A

Urethritis in men

Epididymitis

Prostatitis

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15
Q

what is urethritis?

A
  • yellow purulent exudate (gram stain shows numerous PMNs +GN diplococci)
  • Frequent, painful urination
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16
Q

Gonococcus will lead to what Genito-urinary tract inf. in women?

A

Endocervicitis (Urethritis in females)

17
Q

what is Endocervicitis?

A

Purulent discharge (examine cervix)

Frequent, painful urination, lower abdominal pain

Approx. 50% cases go undetected

18
Q

what complicatins can happen with endocervicitis?

A

Complications include salpinigitis, Pelvic inflammatory disease (PID) and sterility

19
Q

rectal infections iw th neisseria gonorrhoea occur more frequently in whom?

A

in homosexual men

20
Q

Pharyngitis due to neisseria gonorrhea occurs due to what? what is seen?

A

Due to oral-genital contact

Purulent exudate is seen

21
Q

neisseria gonorrhea pharingitis will resemble what?

A

Resembles “Strep” throat

22
Q

what is Ophthalmia neonatorum?

what is another name for this?

what happens if not treated early?

A
  • Redness, swelling of eye, purulent discharge, contracted by newborns during delivery
  • Neonatal conjunctivitis
  • Rapidly leads to blindness if not immediately treated
23
Q

treatment for Ophthalmia neonatorum?

A

1% silver nitrate, 1% tetracycline, or 0.5% erythromycin

24
Q

what are the most common STDs that cause septic neonatal conjunctivitis*?

A

Chlamydia and N.gonorrhea

25
Q

what is Gonococcemia?

A

Disseminated infection - untreated infection which has invaded bloodstream that will Also produces necrotic skin lesions on a erythematous base

26
Q

Gonococcemia Most commonly results in what?

A

septic arthritis *

27
Q

what is Septic Arthritis?

A

Arthritis is inflammation of the joint

28
Q

what is the most common cause of septic arthritis in the sexually active age group?

A

Gonococcus

29
Q

what is the most common cause of septic arthritis in children and adults over 50yrs?

A

Staph. aureus

30
Q

how is Gonococcus diagnosed?

A

Gram stain: (only in male patients *)

  • In males: urethral discharge

Culture:

Thayer Martin media (chocolate agar with antibiotics to supress other bacteria – normal flora) *

Provide 5-10% CO2 *

31
Q

Patients with gonorrhea should be tested for what else?

A

Chlamydia trachomatis infection also (concurrent infection) *

32
Q

what is the Gonococcus – Treatment* * for resistnat to penicillin N.gonorrhea? what is its mechanism of resistance?

how do you treat Due to the many cases of co-existing infection with C. trachomatis ?

A
  • Third generation cephalosporins - Ceftriaxone *
  • Changes in penicillin-binding proteins
  • Doxycycline is added to treatment regime *