NEISSERIANEISSERIAG.HARIPRASAD M.Sc.,(Med micro),M.phil.,Lecturer in MicrobiologyDepartment of MicrobiologyThoothukudi Gov...
HUMAN PATHOGENS• NEISSERIA GONORRHOEA - GONORRHOEA• NEISSERIA MENINGITIDIS - MENINGITISNON-PATHOGENSBRANHAMELLA CATARRHALI...
NEISSERIA GONORRHOEA[GONOCOCCUS]
MORPHOLOGY:• GRAM NEGATIVEDIPLOCOCCI• COCCI ARE ARRANGEDIN PAIRS WITHADJACENT SIDECONCAVE - KIDNEYSHAPED.• INTRACELLULAR.
PATHOGENESIS:MODE OF TRANSMISSION:• SEXUAL CONTACT (STD)VIRULENCE FACTOR:▫ PILI: ATTACHMENT AND ANTIPHAGOCYTIC.▫ CELL WALL...
CLINICAL FEATURES:• ASYMPTOMATIC URETHRAL INFECTION INMALE AND FEMALE – URETHRITIS -DISCHARGE OF PUSIN MEN:• INFLAMMATION ...
OPTHALMIA NEONATORUM:▫ EYE INFECTION IN THE NEWBORN.▫ RESULTS DUE TO DIRECT INFECTIONDURING PASSAGE THROUGH THE BIRTHCANAL.
LAB DIAGNOSISSPECIMEN:• PUS EXUDATES - URETHRAL ANDVAGINAL.• VAGINAL AND CERVICAL SWABS.• TRANSPORT MEDIUM: STUART’SMEDIUM...
LAB DIAGNOSIS- CONT.,CULTURE:• CHOCOLATE AGAR.• SELECTIVE MEDIA: THAYERMARTIN.• INCUBATION AT 37° C IN THEPRESENCE OF 5-10...
TREATMENT:• PENICILLIN.• PPNG (PENICILLINASE PRODUCINGNEISSERIA GONORRHOEA).• TETRACYCLIN IS ADVISABLE.• IF IT FAILS CEPHA...
NON-GONOCOCCAL URETHRITIS• CHRONIC URETHRITIS WHERE GONOCOCCICANNOT BE DEMONSTRATED.• CAN BE CONSIDERED AS NON-SPECIFICURE...
CAUSATIVE AGENTS:• Chlamydia trachomatis• Ureaplasma urelyticum.• Mycoplasma hominis.• Herpes virus• Cytomegalo virus.• Tr...
NEISSERIA MENINGITIDIS[MENINGOCOCCI]
MORPHOLOGY:• GRAM NEGATIVE,SPHERICAL OR OVALDIPLOCOCCI WITHADJACENT SIDEFLATTENED.• THE COCCI AREGENERALLYINTRACELLULARWHE...
ANTIGENIC STRUCTURE:• THIRTEENSEROTYPES BASEDON CAPSULARPOLYSACCHARIDES.• GROUPS A, B AND CARE THE MOSTIMPORTANTSEROTYPES.
PATHOGENESIS:• STRICT HUMAN PATHOGEN.• IT CAUSES PYOGENIC MENINGITIS IN ALLAGES, BUT IS MOST COMMON INCHILDREN AND YOUNG A...
PETECHIAL RASHES IN MENINGOCOCCALSEPTICAEMIA
LAB DIAGNOSISSPECIMENS:• CSF – LUMBARPUNCTURE• BLOOD.• NASOPHARYNGEALSWAB – ESPECIALLY TODETECT CARRIERS.CSF COLLECTIONBY ...
CULTURAL CHARACTERISTICS:• GROWTH OCCURS IN MEDIASUPPLEMENTED WITH BLOOD ORSERUM.• CHOCOLATE AGAR.• BLOOD AGAR.• SELECTIVE...
DIRECT MICROSCOPY:• GRAM NEGATIVE,SPHERICAL OR OVALDIPLOCOCCI WITHADJACENT SIDEFLATTENED.• THE COCCI AREGENERALLYINTRACELL...
BIOCHEMICAL REACTIONS:• CATALASE ANDOXIDASE POSITIVE.• GLUCOSE ANDMALTOSE AREFERMENTED WITHACID PRODUCTIONWITH NO GAS(GONO...
SEROLOGY:• DIRECT SLIDE AGGLUTINATION WITHSPECIFIC ANTISERUM.TREATMENT:• PENICILLIN G – IV• SULPHONAMIDES• CHLORAMPHENICOL...
IMMUNOPROPHYLAXIS:• MONOVALENT ANDPOLYVALENT VACCINEPREPARED FROMPOLYSACCHARIDES OFSEROGROUPS A, C,W135 AND Y ISAVAILABLE.
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  1. 1. NEISSERIANEISSERIAG.HARIPRASAD M.Sc.,(Med micro),M.phil.,Lecturer in MicrobiologyDepartment of MicrobiologyThoothukudi Govt. Medical CollegeThoothukudi
  2. 2. HUMAN PATHOGENS• NEISSERIA GONORRHOEA - GONORRHOEA• NEISSERIA MENINGITIDIS - MENINGITISNON-PATHOGENSBRANHAMELLA CATARRHALIS- NORMAL COMMENSAL CAUSES OPPORTUNISTICINFECTIONS.
  3. 3. NEISSERIA GONORRHOEA[GONOCOCCUS]
  4. 4. MORPHOLOGY:• GRAM NEGATIVEDIPLOCOCCI• COCCI ARE ARRANGEDIN PAIRS WITHADJACENT SIDECONCAVE - KIDNEYSHAPED.• INTRACELLULAR.
  5. 5. PATHOGENESIS:MODE OF TRANSMISSION:• SEXUAL CONTACT (STD)VIRULENCE FACTOR:▫ PILI: ATTACHMENT AND ANTIPHAGOCYTIC.▫ CELL WALL: 2 FACTORS• ENDOTOXIN – TOXIGENICITY.• OUTER MEMBRANE PROTEINS(OMP) -ATTACHMENT• IgA PROTEASE – DESTROYS SECRETORY IgA.REPEATED GONOCOCCAL INFECTION DUE TOCHANGES OF PILI AND OMP
  6. 6. CLINICAL FEATURES:• ASYMPTOMATIC URETHRAL INFECTION INMALE AND FEMALE – URETHRITIS -DISCHARGE OF PUSIN MEN:• INFLAMMATION OF THE PERIURETHRALTISSUE CAUSES ABCESS AND MULTIPLEDISCHARGING SINUSES [WATERCANPERINIUM].• INFECTION EXTENDS ALONG THEURETHRA TO PROSTATE, SEMINAL VESICLEAND EPIDIDYMIS.IN WOMEN:• VULVOVAGINITIS – MUCOPURULENTDISCHARGE.• SALPINGITIS - INFECTION OF THEFALLOPIAN TUBES.• CERVICITIS.• PELVIC INFLAMMATORY DISEASE.
  7. 7. OPTHALMIA NEONATORUM:▫ EYE INFECTION IN THE NEWBORN.▫ RESULTS DUE TO DIRECT INFECTIONDURING PASSAGE THROUGH THE BIRTHCANAL.
  8. 8. LAB DIAGNOSISSPECIMEN:• PUS EXUDATES - URETHRAL ANDVAGINAL.• VAGINAL AND CERVICAL SWABS.• TRANSPORT MEDIUM: STUART’SMEDIUM.DIRECT MICROSCOPY:• INTRACELLULAR GRAM NEGATIVEKIDNEY SHAPED DIPLOCOCCI.• FLUORESCENT ANTIBOBYTECHNIQUE –RAPID, SENSITIVEAND SPECIFIC DIAGNOSIS. INTRACELLULAR GRAMNEGATIVE DIPLOCOCCI
  9. 9. LAB DIAGNOSIS- CONT.,CULTURE:• CHOCOLATE AGAR.• SELECTIVE MEDIA: THAYERMARTIN.• INCUBATION AT 37° C IN THEPRESENCE OF 5-10% OF CARBONDIOXIDE.BIOCHEMICAL REACTION:• GLUCOSE FERMENTATION.• OXIDASE POSITIVE.SEROLOGY:• IMMUNOFLUORESCENCE.• RIA.• ELISAIMMUNOFLUORESCENCE
  10. 10. TREATMENT:• PENICILLIN.• PPNG (PENICILLINASE PRODUCINGNEISSERIA GONORRHOEA).• TETRACYCLIN IS ADVISABLE.• IF IT FAILS CEPHALOSPORINS AREUSED.• 1% SILVER NITRATE FOR OPTHALMIANEONATORUM.
  11. 11. NON-GONOCOCCAL URETHRITIS• CHRONIC URETHRITIS WHERE GONOCOCCICANNOT BE DEMONSTRATED.• CAN BE CONSIDERED AS NON-SPECIFICURETHRITIS.• URETHRITIS FORMS PART OF THESYNDROME CONSISTING OF CONJUNCTIVITISAND ARTHRITIS (REITER’S SYNDROME).• MAY BE ALSO DUE TO GONOCOCCALINFECTION, THE COCCI PERSISTING AS L-FORMS AND HENCE UNDETECTABLE BYROUTINE TESTS.
  12. 12. CAUSATIVE AGENTS:• Chlamydia trachomatis• Ureaplasma urelyticum.• Mycoplasma hominis.• Herpes virus• Cytomegalo virus.• Trichomonas vaginalis.• Candida albicans.• CAN ALSO BE DUE TO MECHANICAL ORCHEMICAL IRRITATION.• MANAGEMENT: DIFFICULT.
  13. 13. NEISSERIA MENINGITIDIS[MENINGOCOCCI]
  14. 14. MORPHOLOGY:• GRAM NEGATIVE,SPHERICAL OR OVALDIPLOCOCCI WITHADJACENT SIDEFLATTENED.• THE COCCI AREGENERALLYINTRACELLULARWHEN ISOLATEDFROM LESIONS.
  15. 15. ANTIGENIC STRUCTURE:• THIRTEENSEROTYPES BASEDON CAPSULARPOLYSACCHARIDES.• GROUPS A, B AND CARE THE MOSTIMPORTANTSEROTYPES.
  16. 16. PATHOGENESIS:• STRICT HUMAN PATHOGEN.• IT CAUSES PYOGENIC MENINGITIS IN ALLAGES, BUT IS MOST COMMON INCHILDREN AND YOUNG ADULTS.• THE INFECTION IS ACQUIRED BYDROPLET SPREAD.• 2 CLINICAL TYPES:▫ CEREBROSPINAL MENINGITIS▫ MENINGOCOCCAL SEPTICEMIA.• SEPTICEMIA PRESENTS AS ACUTE FEVERWITH PETICHIAL RASH.• A FEW DEVELOPS FULMINANTMENINGOCOCCAEMIA(WATERHOUSE FRIDERICHSEN SYNDROME)CHARACTERIZED BY SHOCKDISSEMINATED INTRAVASCULARCOAGULATION AND MULTISYSTEMFAILURE.
  17. 17. PETECHIAL RASHES IN MENINGOCOCCALSEPTICAEMIA
  18. 18. LAB DIAGNOSISSPECIMENS:• CSF – LUMBARPUNCTURE• BLOOD.• NASOPHARYNGEALSWAB – ESPECIALLY TODETECT CARRIERS.CSF COLLECTIONBY LUMBARPUNCTURE
  19. 19. CULTURAL CHARACTERISTICS:• GROWTH OCCURS IN MEDIASUPPLEMENTED WITH BLOOD ORSERUM.• CHOCOLATE AGAR.• BLOOD AGAR.• SELECTIVE MEDIUM: THAYER MARTINMEDIUM.• GROWTH IS ENHANCED IN 5-10%CARBON DIOXIDE.
  20. 20. DIRECT MICROSCOPY:• GRAM NEGATIVE,SPHERICAL OR OVALDIPLOCOCCI WITHADJACENT SIDEFLATTENED.• THE COCCI AREGENERALLYINTRACELLULARWHEN ISOLATEDFROM LESIONS.INTRACELLULAR GRAMNEGATIVE DIPLOCOCCI
  21. 21. BIOCHEMICAL REACTIONS:• CATALASE ANDOXIDASE POSITIVE.• GLUCOSE ANDMALTOSE AREFERMENTED WITHACID PRODUCTIONWITH NO GAS(GONOCOCCIFERMENTS GLUCOSEBUT NOT MALTOSE).
  22. 22. SEROLOGY:• DIRECT SLIDE AGGLUTINATION WITHSPECIFIC ANTISERUM.TREATMENT:• PENICILLIN G – IV• SULPHONAMIDES• CHLORAMPHENICOL• CEPHALOSPORIN.• RIFAMPICIN AND CIPROFLOXACIN –FOR CARRIERS
  23. 23. IMMUNOPROPHYLAXIS:• MONOVALENT ANDPOLYVALENT VACCINEPREPARED FROMPOLYSACCHARIDES OFSEROGROUPS A, C,W135 AND Y ISAVAILABLE.

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