Gonorrhea

Introduction. 

Gonorrhea is the second-most common STD in the US and has an exclusively human reservoir. Its ability to adhere to the urethral lining, infect host cells, and evade the immune system are largely responsible for its pathogenicity. N. gonorrhoeae has lipooligosaccharide (LOS, an endotoxin) and IgA protease. It survives inside host macrophages by inhibiting phagolysosme fusion. LOS causes inflammation and symptoms of gonorrhea. Neisseria are oxidase-positive Gram-negative diplococci; their presence in phagocytic cells and their selective growth on Thayer-Martin medium (w/ oxidase reaction) are sufficient for identification.

Summary

• Cause: Neisseria gonorrhoeae
• Microscopy: Gram-negative diplococci, often intracellular in PMN
• Culture: Thayer-Martin medium
• Transmission: STD
• Symptoms: Painful urination, pus-filled discharge (penis, vagina)
• Complications: Pelvic inflammatory disease, other ascending infections
• Pathogenesis: Attachment to urethra allows Neisseria to replicate. Intracellular survival of Neisseria in local macrophages, production of endotoxin, inflammation + cause release of TNF-a
• Treatment: Ceftriaxone, cefixime, ciprofloxacin or ofloxacin