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Neisseria gonorrhoeae

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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