USMLE

Neisseria gonorrhoeae

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Bacteria - Gram Negative
  1. Neisseria spp: Overview
  2. Neisseria gonorrhoeae
  3. Neisseria meningitidis
  4. Haemophilus influenzae
  5. Bordetella pertussis
  6. Brucella
  7. Legionella pneumophila
  8. Pseudomonas aeruginosa: Overview
  9. Pseudomonas aeruginosa: Disease
  10. Salmonella Overview
  11. Salmonella typhi
  12. Salmonella enteritidis
  13. Shigella
  14. Yersinia enterocolitica
  15. Escherichia coli: Overview
  16. Enterohemorrhagic E. Coli (EHEC)
  17. Enterotoxigenic E. Coli (ETEC)
  18. Klebsiella pneumoniae
  19. Campylobacter jejuni
  20. Vibrio spp.
  21. Helicobacter pylori
  22. Borrelia burgdorferi (Lyme Disease)
  23. Leptospira interrogans
  24. Treponema pallidum: Overview
  25. Treponema pallidum: Diagnosis
  26. Congenital syphilis
  27. Chlamydia: Overview
  28. Chlamydia trachomatis
  29. Chlamydia pneumoniae vs. psittaci
  30. Rickettsia rickettsii
  31. Rickettsia typhi vs. prowazekii
  32. Anaplasma vs. Ehrlichia
  33. Coxiella burnetii (Q fever)

Neisseria gonorrhoeae

  • Unique Characteristics
    • See Neisseria Overview for characteristics to all Neisseria spp.
    • No polysaccharide capsule 
      • Contrast vs. N meningitidis - polysaccharide capsule present
    • No maltose acid detection
      • Contrast vs. N meningitidis - maltose acid detection 
  • Sexually-transmitted
    • Second most common STI in US (after Chlamydia)
    • May also be perinatally transmitted 
  • Disease: Gonorrhea
    • Urethritis/cervicitis
      • Dysuria
      • Purulent discharge 
        • Contrast with Chlamydia, which has watery discharge 
    • Pelvic inflammatory disease (PID) 
      • Occur with poor treatment of initial infection
      • Fitz-Hugh-Curtis syndrome 
        • Perihepatitis - infection and inflammation of liver capsule 
        • Violin string” adhesions of peritoneum to liver 
    • Septic arthritis 
      • Staph aureus is the most common cause of septic arthritis, but suspect N. gonorrhoeae in sexually active young adults, especially IV drug users 
    • Arthritis, pharyngitis, dermatitis, tenosynovitis may also be seen in disseminated gonorrheal infections
    • Neonatal conjunctivitis (2- 5 days after birth) in perinatal infections
  • Treatment
    • Ceftriaxone
      • Intramuscular injection of ceftriaxone is first-line for gonococcal infections
      • must treat for chlamydia coinfection with azithromycin or doxycycline
        • Inadequate treatment can result in PID and future infertility or other complications (ectopic pregnancy)
    • Erythromycin eye ointment prevents neonatal blindness