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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

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