<ul><li>NEISSERIA </li></ul>G.HARIPRASAD M.Sc.,(Med micro),M.phil., Lecturer in Microbiology  Department of Microbiology  ...
<ul><li>HUMAN PATHOGENS </li></ul><ul><li>NEISSERIA GONORRHOEA - GONORRHOEA </li></ul><ul><li>NEISSERIA MENINGITIDIS -  ME...
NEISSERIA GONORRHOEA [GONOCOCCUS]
<ul><li>MORPHOLOGY:  </li></ul><ul><li>GRAM NEGATIVE DIPLOCOCCI </li></ul><ul><li>COCCI ARE ARRANGED IN PAIRS WITH ADJACEN...
PATHOGENESIS: <ul><li>MODE OF TRANSMISSION:  </li></ul><ul><li>SEXUAL CONTACT (STD) </li></ul><ul><li>VIRULENCE FACTOR: </...
CLINICAL FEATURES: <ul><li>ASYMPTOMATIC URETHRAL INFECTION IN MALE AND FEMALE –  URETHRITIS  - DISCHARGE OF PUS  </li></ul...
OPTHALMIA NEONATORUM: <ul><ul><li>EYE INFECTION IN THE NEWBORN. </li></ul></ul><ul><ul><li>RESULTS DUE TO DIRECT INFECTION...
LAB DIAGNOSIS <ul><li>SPECIMEN:  </li></ul><ul><li>PUS EXUDATES - URETHRAL AND VAGINAL. </li></ul><ul><li>VAGINAL AND CERV...
LAB DIAGNOSIS- CONT., <ul><li>CULTURE: </li></ul><ul><li>CHOCOLATE AGAR. </li></ul><ul><li>SELECTIVE MEDIA: THAYER MARTIN....
TREATMENT: <ul><li>PENICILLIN. </li></ul><ul><li>PPNG (PENICILLINASE PRODUCING    NEISSERIA GONORRHOEA). </li></ul><ul><li...
NON-GONOCOCCAL URETHRITIS <ul><li>CHRONIC URETHRITIS WHERE GONOCOCCI CANNOT BE DEMONSTRATED. </li></ul><ul><li>CAN BE CONS...
CAUSATIVE AGENTS: <ul><li>Chlamydia trachomatis </li></ul><ul><li>Ureaplasma urelyticum. </li></ul><ul><li>Mycoplasma homi...
NEISSERIA MENINGITIDIS [MENINGOCOCCI]
MORPHOLOGY: <ul><li>GRAM NEGATIVE, SPHERICAL OR OVAL DIPLOCOCCI WITH ADJACENT SIDE FLATTENED. </li></ul><ul><li>THE COCCI ...
ANTIGENIC STRUCTURE: <ul><li>THIRTEEN SEROTYPES BASED ON CAPSULAR  POLYSACCHARIDES. </li></ul><ul><li>GROUPS A, B AND C AR...
PATHOGENESIS: <ul><li>STRICT HUMAN PATHOGEN. </li></ul><ul><li>IT CAUSES PYOGENIC MENINGITIS IN ALL AGES, BUT IS MOST COMM...
PETECHIAL RASHES IN MENINGOCOCCAL SEPTICAEMIA
LAB DIAGNOSIS <ul><li>SPECIMENS: </li></ul><ul><li>CSF – LUMBAR PUNCTURE  </li></ul><ul><li>BLOOD. </li></ul><ul><li>NASOP...
CULTURAL CHARACTERISTICS: <ul><li>GROWTH OCCURS IN MEDIA SUPPLEMENTED WITH BLOOD OR SERUM. </li></ul><ul><li>CHOCOLATE AGA...
DIRECT MICROSCOPY : <ul><li>GRAM NEGATIVE, SPHERICAL OR OVAL DIPLOCOCCI WITH ADJACENT SIDE FLATTENED.  </li></ul><ul><li>T...
BIOCHEMICAL  REACTIONS: <ul><li>CATALASE AND OXIDASE POSITIVE. </li></ul><ul><li>GLUCOSE AND MALTOSE ARE FERMENTED WITH AC...
<ul><li>SEROLOGY: </li></ul><ul><li>DIRECT SLIDE AGGLUTINATION WITH SPECIFIC ANTISERUM. </li></ul><ul><li>TREATMENT: </li>...
<ul><li>IMMUNOPROPHYLAXIS: </li></ul><ul><li>MONOVALENT AND POLYVALENT VACCINE PREPARED FROM POLYSACCHARIDES OF SEROGROUPS...
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Neisseria, gonorrhoea, STD, meningitis, meningococci, gonococci, bacterial infections,sexually transmitted disease

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Neisseria, gonorrhoea, STD, meningitis, meningococci, gonococci, bacterial infections,sexually transmitted disease

  1. 1. <ul><li>NEISSERIA </li></ul>G.HARIPRASAD M.Sc.,(Med micro),M.phil., Lecturer in Microbiology Department of Microbiology Thoothukudi Govt. Medical College Thoothukudi
  2. 2. <ul><li>HUMAN PATHOGENS </li></ul><ul><li>NEISSERIA GONORRHOEA - GONORRHOEA </li></ul><ul><li>NEISSERIA MENINGITIDIS - MENINGITIS </li></ul>NON-PATHOGENS BRANHAMELLA CATARRHALIS - NORMAL COMMENSAL CAUSES OPPORTUNISTIC INFECTIONS.
  3. 3. NEISSERIA GONORRHOEA [GONOCOCCUS]
  4. 4. <ul><li>MORPHOLOGY: </li></ul><ul><li>GRAM NEGATIVE DIPLOCOCCI </li></ul><ul><li>COCCI ARE ARRANGED IN PAIRS WITH ADJACENT SIDE CONCAVE - KIDNEY SHAPED. </li></ul><ul><li>INTRACELLULAR. </li></ul>
  5. 5. PATHOGENESIS: <ul><li>MODE OF TRANSMISSION: </li></ul><ul><li>SEXUAL CONTACT (STD) </li></ul><ul><li>VIRULENCE FACTOR: </li></ul><ul><ul><li>PILI: ATTACHMENT AND ANTIPHAGOCYTIC. </li></ul></ul><ul><ul><li>CELL WALL: 2 FACTORS </li></ul></ul><ul><li>ENDOTOXIN – TOXIGENICITY. </li></ul><ul><li>OUTER MEMBRANE PROTEINS(OMP) - ATTACHMENT </li></ul><ul><li>IgA PROTEASE – DESTROYS SECRETORY IgA. </li></ul><ul><ul><li>REPEATED GONOCOCCAL INFECTION DUE TO CHANGES OF PILI AND OMP </li></ul></ul>
  6. 6. CLINICAL FEATURES: <ul><li>ASYMPTOMATIC URETHRAL INFECTION IN MALE AND FEMALE – URETHRITIS - DISCHARGE OF PUS </li></ul><ul><li>IN MEN: </li></ul><ul><li>INFLAMMATION OF THE PERIURETHRAL TISSUE CAUSES ABCESS AND MULTIPLE DISCHARGING SINUSES [WATERCAN PERINIUM]. </li></ul><ul><li>INFECTION EXTENDS ALONG THE URETHRA TO PROSTATE, SEMINAL VESICLE AND EPIDIDYMIS. </li></ul><ul><li>IN WOMEN: </li></ul><ul><li>VULVOVAGINITIS – MUCOPURULENT DISCHARGE. </li></ul><ul><li>SALPINGITIS - INFECTION OF THE FALLOPIAN TUBES. </li></ul><ul><li>CERVICITIS. </li></ul><ul><li>PELVIC INFLAMMATORY DISEASE. </li></ul>
  7. 7. OPTHALMIA NEONATORUM: <ul><ul><li>EYE INFECTION IN THE NEWBORN. </li></ul></ul><ul><ul><li>RESULTS DUE TO DIRECT INFECTION DURING PASSAGE THROUGH THE BIRTH CANAL. </li></ul></ul>
  8. 8. LAB DIAGNOSIS <ul><li>SPECIMEN: </li></ul><ul><li>PUS EXUDATES - URETHRAL AND VAGINAL. </li></ul><ul><li>VAGINAL AND CERVICAL SWABS. </li></ul><ul><li>TRANSPORT MEDIUM: STUART’S MEDIUM. </li></ul><ul><li>DIRECT MICROSCOPY: </li></ul><ul><li>INTRACELLULAR GRAM NEGATIVE KIDNEY SHAPED DIPLOCOCCI. </li></ul><ul><li>FLUORESCENT ANTIBOBY TECHNIQUE –RAPID, SENSITIVE AND SPECIFIC DIAGNOSIS. </li></ul>INTRACELLULAR GRAM NEGATIVE DIPLOCOCCI
  9. 9. LAB DIAGNOSIS- CONT., <ul><li>CULTURE: </li></ul><ul><li>CHOCOLATE AGAR. </li></ul><ul><li>SELECTIVE MEDIA: THAYER MARTIN. </li></ul><ul><li>INCUBATION AT 37° C IN THE PRESENCE OF 5-10% OF CARBON DIOXIDE. </li></ul><ul><li>BIOCHEMICAL REACTION: </li></ul><ul><li>GLUCOSE FERMENTATION. </li></ul><ul><li>OXIDASE POSITIVE. </li></ul><ul><li>SEROLOGY: </li></ul><ul><li>IMMUNOFLUORESCENCE. </li></ul><ul><li>RIA. </li></ul><ul><li>ELISA </li></ul>IMMUNOFLUORESCENCE
  10. 10. TREATMENT: <ul><li>PENICILLIN. </li></ul><ul><li>PPNG (PENICILLINASE PRODUCING NEISSERIA GONORRHOEA). </li></ul><ul><li>TETRACYCLIN IS ADVISABLE. </li></ul><ul><li>IF IT FAILS CEPHALOSPORINS ARE USED. </li></ul><ul><li>1% SILVER NITRATE FOR OPTHALMIA NEONATORUM. </li></ul>
  11. 11. NON-GONOCOCCAL URETHRITIS <ul><li>CHRONIC URETHRITIS WHERE GONOCOCCI CANNOT BE DEMONSTRATED. </li></ul><ul><li>CAN BE CONSIDERED AS NON-SPECIFIC URETHRITIS. </li></ul><ul><li>URETHRITIS FORMS PART OF THE SYNDROME CONSISTING OF CONJUNCTIVITIS AND ARTHRITIS (REITER’S SYNDROME). </li></ul><ul><li>MAY BE ALSO DUE TO GONOCOCCAL INFECTION, THE COCCI PERSISTING AS L-FORMS AND HENCE UNDETECTABLE BY ROUTINE TESTS. </li></ul>
  12. 12. CAUSATIVE AGENTS: <ul><li>Chlamydia trachomatis </li></ul><ul><li>Ureaplasma urelyticum. </li></ul><ul><li>Mycoplasma hominis. </li></ul><ul><li>Herpes virus </li></ul><ul><li>Cytomegalo virus. </li></ul><ul><li>Trichomonas vaginalis. </li></ul><ul><li>Candida albicans. </li></ul><ul><li>CAN ALSO BE DUE TO MECHANICAL OR CHEMICAL IRRITATION. </li></ul><ul><li>MANAGEMENT: DIFFICULT. </li></ul>
  13. 13. NEISSERIA MENINGITIDIS [MENINGOCOCCI]
  14. 14. MORPHOLOGY: <ul><li>GRAM NEGATIVE, SPHERICAL OR OVAL DIPLOCOCCI WITH ADJACENT SIDE FLATTENED. </li></ul><ul><li>THE COCCI ARE GENERALLY INTRACELLULAR WHEN ISOLATED FROM LESIONS. </li></ul>
  15. 15. ANTIGENIC STRUCTURE: <ul><li>THIRTEEN SEROTYPES BASED ON CAPSULAR POLYSACCHARIDES. </li></ul><ul><li>GROUPS A, B AND C ARE THE MOST IMPORTANT SEROTYPES. </li></ul>
  16. 16. PATHOGENESIS: <ul><li>STRICT HUMAN PATHOGEN. </li></ul><ul><li>IT CAUSES PYOGENIC MENINGITIS IN ALL AGES, BUT IS MOST COMMON IN CHILDREN AND YOUNG ADULTS. </li></ul><ul><li>THE INFECTION IS ACQUIRED BY DROPLET SPREAD. </li></ul><ul><li>2 CLINICAL TYPES: </li></ul><ul><ul><li>CEREBROSPINAL MENINGITIS </li></ul></ul><ul><ul><li>MENINGOCOCCAL SEPTICEMIA. </li></ul></ul><ul><li>SEPTICEMIA PRESENTS AS ACUTE FEVER WITH PETICHIAL RASH. </li></ul><ul><li>A FEW DEVELOPS FULMINANT MENINGOCOCCAEMIA </li></ul><ul><li>(WATERHOUSE FRIDERICHSEN SYNDROME) CHARACTERIZED BY SHOCK DISSEMINATED INTRAVASCULAR COAGULATION AND MULTISYSTEM FAILURE. </li></ul>
  17. 17. PETECHIAL RASHES IN MENINGOCOCCAL SEPTICAEMIA
  18. 18. LAB DIAGNOSIS <ul><li>SPECIMENS: </li></ul><ul><li>CSF – LUMBAR PUNCTURE </li></ul><ul><li>BLOOD. </li></ul><ul><li>NASOPHARYNGEAL SWAB – ESPECIALLY TO DETECT CARRIERS. </li></ul>CSF COLLECTION BY LUMBAR PUNCTURE
  19. 19. CULTURAL CHARACTERISTICS: <ul><li>GROWTH OCCURS IN MEDIA SUPPLEMENTED WITH BLOOD OR SERUM. </li></ul><ul><li>CHOCOLATE AGAR. </li></ul><ul><li>BLOOD AGAR. </li></ul><ul><li>SELECTIVE MEDIUM: THAYER MARTIN MEDIUM. </li></ul><ul><li>GROWTH IS ENHANCED IN 5-10% CARBON DIOXIDE. </li></ul>
  20. 20. DIRECT MICROSCOPY : <ul><li>GRAM NEGATIVE, SPHERICAL OR OVAL DIPLOCOCCI WITH ADJACENT SIDE FLATTENED. </li></ul><ul><li>THE COCCI ARE GENERALLY INTRACELLULAR WHEN ISOLATED FROM LESIONS. </li></ul>INTRACELLULAR GRAM NEGATIVE DIPLOCOCCI
  21. 21. BIOCHEMICAL REACTIONS: <ul><li>CATALASE AND OXIDASE POSITIVE. </li></ul><ul><li>GLUCOSE AND MALTOSE ARE FERMENTED WITH ACID PRODUCTION WITH NO GAS (GONOCOCCI FERMENTS GLUCOSE BUT NOT MALTOSE). </li></ul>
  22. 22. <ul><li>SEROLOGY: </li></ul><ul><li>DIRECT SLIDE AGGLUTINATION WITH SPECIFIC ANTISERUM. </li></ul><ul><li>TREATMENT: </li></ul><ul><li>PENICILLIN G – IV </li></ul><ul><li>SULPHONAMIDES </li></ul><ul><li>CHLORAMPHENICOL </li></ul><ul><li>CEPHALOSPORIN. </li></ul><ul><li>RIFAMPICIN AND CIPROFLOXACIN – FOR CARRIERS </li></ul>
  23. 23. <ul><li>IMMUNOPROPHYLAXIS: </li></ul><ul><li>MONOVALENT AND POLYVALENT VACCINE PREPARED FROM POLYSACCHARIDES OF SEROGROUPS A, C, W135 AND Y IS AVAILABLE. </li></ul>

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