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CMMRS > Chapter 8: Neisseria > Flashcards

Chapter 8: Neisseria Flashcards

1
Q

Neisseria

A

Only pathogenic gram-negative cocci

Pairs = diplococci

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2
Q

What does Neisseria meningitidis cause?

A

Meningitis

Life-threatening sepsis (meningococcemia)

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3
Q

What are the virulence factors of the meningococcus?

A

Capsule: A, B, C
Endotoxin (LPS)
IgA1 protease: Exclusive to Neisseria, cleaves IgA in half
and Pili : attachment

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4
Q

What does Endotoxin LPS from meningococcus cause?

A

Blood vessel destruction (hemorrhage) and sepsis
Petechiae
Can damage adrenal glands

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5
Q

What are the high risk groups for infection by Neisseria meningitidis (meningococcus)

A

Infants aged 6 months to 2 years
Army recruits
College freshmen

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6
Q

How does Neisseria meningitidis spread?

A

via respiratory secretions and usually lives asymptomatically in the nasopharynx

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7
Q

What is the major clue to for invasive meningococcal infection?

A

petechial rash

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8
Q

What is Meningococcemia

A

Intravascular infection of Neisseria meningitidis

Abrupt onset of spiking fevers, chills, arthralgia (joint pains) and muscle pains, and petechial rash

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9
Q

What is Fulminant meningococcemia?

A

It is the waterhouse-friederichsen syndrome
Septic shock
Bilateral hemorrhage into the adrenal glands ->adrenal insufficiency
Hypotension and tachycardia abruptly occurs
Rapily enlarging petechial skin lesions
DIC, coma

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10
Q

What is the most common form of meningococcal disease?

A

Meningitis: striking infants less than a year of age
Fever, vomiting, irritability and/or lethargy
Bulging open anterior fontanelle
Slightly older infants may develop stiff neck and positive Kernig’s and Brudzinski’s signs

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11
Q

What does Neisseria gonorrhoeae/gonococcus cause?

A

The SECOND most common sexually transmitted disease, gonorrhea

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12
Q

What are the Virulence factors of gonococcus?

A

Pili, outer membrane protein porins

Opa proteins

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13
Q

What virulence factor of gonococcus protects the bacteria from our Abs, vaccines, and also serves to prevent phagocytosis?

A

Pili
Hypervariable amino acid sequences
Pili also possibly hold the bacteria so close to host cells that Mo or neurtrophils are unable to attack

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14
Q

What is the role of outer membrane protein porins of gonoccucus?

A

PorA and PorB appear to promote invasion into epithelial cells

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15
Q

What are opa proteins?

A

class of outer membrane proteins that promote adherence and invasion into epithelial cells; expression results in opaque colonies

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16
Q

What do pili, porins and opa proteins allow gonoccoci to do overall?

A

bind to fallopian tube non-ciliated eipthelial cells where LPS can destroy cells

17
Q

Gonococcal disease in men

A

Organisms penetrates the mucous membranes of the urethra, causing inflammation (urethritis), dysuria, and purulent discharge from the penis. Both symptomatic and asymptomatic men pass the disease

Epididymitis, prostatitis, and urethral strictures
MSM: rectal gonococcal infection

18
Q

What are the symptoms of Gonococcal disease in men?

A

Painful urination along with a purulent urethral discharge (pus expressed from tip of penis)

19
Q

Gonococcal disease in women

A

More likely to be asymptomatic with minimal urethral discharge
Infects columnar epithelium of the cervix - reddened, friable, purulent exudate
Both symptomatic and asymptomatic women can transmit the disease

20
Q

What are the symptoms of Gonococcal disease in women?

A

If symptoms do develop, the women may complain of lower abdominal discomfort pain with sexual intercourse
Purulent vaginal discharge

21
Q

What can gonococcal infection of the cervix progress to?

A

PID - pelvic inflammatory disease
Infection of the uterus (endometritis), fallopian tubes (salpinitis), and/or ovaries (oophoritis)

Low fever, lower abdominal pain, abnormal menstrual bleeding, cervical m otion tenderness

Menstruation allows bacteria to spread

22
Q

What can increase the risk of cervical gonococcal infection progressing to PID?

A

IUD

23
Q

What is the major cause of PID?

A

Chlamydia trachomatis

24
Q

What are the complications of PID?

A

Sterility: scarring
Ectopic pregnancy: salpingitis and scaring
Abscesses: in fallopian tubes, ovaries, or peritoneum
Peritonitis: infected peritoneal fluid
Peri-hepatitis: capsule around liver

25
Q

What is Fitz-Hugh-Curtis syndrome?

A 
Peri-hepatitis 
Infection of Neisseria gonorrhoeae of the capsule that surrounds the liver
RUQ pain and tenderness
Follows PID 
Also PID by chlamydia
26
Q

Gonococcal bacteremia

A

Rarely Neisseria gonorrhoeae can invade the bloodstream
Men and women
Fever, joint pain, skin lesions on extremities
Pericarditis, endocarditis, and meningitis rare complications

27
Q

Gonococcal septic arthritis

A 
Acute onset of fever along with pain and swelling of 1 or 2 joints 
Pregressive destruction of joint 
Synovial fluid reveals increased WBCs
Gram stain and culture of fluid 
diplococci within WBC
28
Q

What is the most common kind of septic arthritis in young, sexually active individuals?

A

Gonococcal arthritis

29
Q

Gonococcal disease in infants

A

Transmitted during delivery

Results in opthalmia neonatorum - eye infection that can cause blindness (can also occur in adults)

30
Q

What does Moraxella (Branhamella) catarrhalis cause?

A

Otitis media and URI in pts with COPD or emphysema or in the elderly

Pneumonia in the elderly

31
Q

What group commonly has otitis media?

A

80% of all children by 3 years of age

32
Q

What is otitis media mainly cuased by?

A

Strep penumoniae, Haemophilus influenzae and Moraxella catarrhalis (decreasing order)

33
Q

Worsening of wheezing, shortness of breath and cough - COPD exacerbations are often associated with what?

A

acquisition of a new strain of nontypeable Haemophilus influenzae or infection with Moraxella catarrhalis

34
Q

Kingella kingae

A

frequently colonizes the throats of young children and can cause septic arthritis and osteomyelitis in children
Can cause endocarditis of native and prosthetic vavles in adults and children

35
Q

What are the slow growing gram negative pathogens known to cause endocarditis?

A 
HACEK group 
Haemophilus species
Actinobacillus species 
Cardiobacterium species
Eikenella species
Kingella species

CMMRS (27 decks)

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