MODULE 4 (UNIT 3) Flashcards
Different from the staphylococci and streptococci, bacteria included in this module unit are [1] which are classified under the genera Neisseria
- gram-negative cocci
The genus [1] contains the [2] which are established as human pathogens. These pathogenic species are [3a], the cause of gonorrhea, and [3b], a major cause of meningitis and bacteremia. [3c] is always considered a pathogen, regardless of the site of isolation.
[4] may also colonize the human nasopharynx without causing disease
- Neisseria
- two gram-negative cocci
- Neisseria gonorrhoeae; Neisseria meningitidis; N. gonorrhoeae
- N. meningitis
The genus also includes many [1], most of which are harmless inhabitants of the mucus membranes of the [2]. These other neisseriae found in humans include [3 - 8]
- commensal species
- upper respiratory and alimentary tracts
- N. lactamica
- N. sicca
- N. subflava
- N.musosa
- N. flavens
- N. cinerea
- N. polysaccharea-N. elongata
Neisseria gonorrhoeae
Common name:
Gonococcus
[1]
HABITAT AND TRANSMISSION
•NOT considered [2]. Only found on the mucous membranes of the [3] at time of infection; typically are found associated with or inside [4] cells.
•Transmission is primarily by direct contact ([5])
- Neisseria gonorrhoeae
- normal flora
- genitourinary tract, rectum, throat, and the eye
- polymorphonuclear
- sexually or perinatally
[1]
•Asexually transmitted infection (STI)in both men and women, characterized by invasion of the mucous membranes of the genital tract causing inflammation; also of the [2.
- Gonorrhea
2. rectum and the throat
Genital gonorrhea
•In males:
-Primary site of infection is the [1].
-Incubation period ranges from [2a] or longer, with an average of [2b]
-Symptoms of [3] occur in 90-95% of infected males
‣ [4a] (burning sensation during urination)
‣ [4b] (yellow, creamy pus)
-If left untreated, ascending infection may result in epididymitis, [5] (inflammation of the testicles), epididymo-orchitis, prostatitis, periurethral abscess, and urethral stricture, which can reduce [6a] and can lead to [6b]
- urethra
- 1 to 14 days; 2 to 7 days.
- urethritis
4a. dysuria; purulent urethral discharge - orchitis
6a. sperm passage; sterility
In females:
-Primary site of infection is the [1], with concomitant urethral infection.
-Incubation period of [2],
-Symptoms of [3] in 10-20% of infected females
‣ purulent cervicovaginal discharge
‣ dysuria
‣ [4a] (intermenstrual bleeding)
‣ [4b] (painful vaginal intercourse)
-In untreated cases, ascending infection may occur and can result in [5] (PID) that is manifested as salpingitis (infection of the Fallopian tubes), endometritis, and tubo-ovarian abscess.
[6] is a risk factor for ectopic pregnancy, infertility, chronic pelvic pain, and [7] — a perihepatitis, an infection and inflammation of liver capsule and “violin string” adhesions of peritoneum to liver
- endocervix
- 8 to 10 days
- endocervicitisoccur
- menorrhagia; dyspareunia
- pelvic inflammatory disease
- Salpingitis
- Fitz–Hugh–Curtis syndrome
When gonorrhea is present in a child after the [1], this infection may be a sign of sexual abuse.
•In prepubertal girls, gonorrhea manifests as a [2] with a vaginal discharge, rather than a cervicitis. The epithelium of the prepubertal vagina is composed of [3], which are the cell types that N. gonorrhoeae preferentially infects. With the onset of puberty, these cells are replaced by a [4] that is not susceptible to gonococcal infection
- newborn period and before puberty
- vaginitis
- columnar epithelial cells
- stratified squamous epithelium
Extragenital gonorrhea
[1]
- Seen in MSM (men having sex with men) and women who acquire the infection by engaging in orogenital sexual contact with an infected partner.
- Over 90% are asymptomatic.
- Patients with oropharyngeal gonococcal infection often have gonococcal infection at genital and/or rectal sites as well
[2]
-Seen primarily in MSM who practice unprotected receptive anal intercourse; among MSM, gonococcal infection of the rectum may be the only infected anatomic site.
-Women may also acquire rectal infections by receptive anal
intercourse, but most rectal infections in women are due to perianal contamination with infected cervicovaginal secretions.
-Are often asymptomatic, but some individuals may experience
symptoms ranging from mild pruritis to acute proctitis with anorectal pain and itching, a mucopurulent discharge, bleeding, tenesmus, and constipation 5 to 7 days following infection.
[3]
- Painful, purulent conjunctivitis
- Occurs in adults who become infected by self-inoculation of the eyes from genital secretions
- • Oropharyngeal gonococcal infection
- • Anorectal gonococcal infection
- •Ocular gonococcal infection
[1]
•An infection of the eye in newborns
•Acquired during passage through the birth canal of an infected mother.
•Initial purulent conjunctivitis occurs 2-5 days after birth, rapidly progresses and, if untreated, results in blindness
- Gonococcal ophthalmia neonatorum
[1]
•Results from the spread of gonococci into the bloodstream
•Characterized by low-grade fever, painful, hemorrhagic skin lesions (initially appear as papules that evolve into necrotic pustules) on the hands, forearms, feet, and legs; tenosynovitis and suppurative arthritis, usually of the knees, ankles, and wrists.
•Complications include permanent joint damage, endocarditis, and rarely, meningitis
- Disseminated Gonococcal Infection (DGI)
[1]
•Enhance attachment of [2a] and resistance to [2b]
•Undergo [3] (with more than 1 million pilin protein variants) such that pilins of almost all strains of N gonorrhoeae are antigenically different, and a single strain can make many antigenically distinct forms of pilin
- Pili
- gonococci to host cells; phagocytosis
- antigenic variation
Outer Membrane Proteins (OM Proteins)
a. [1]
-Associated with [2]
-Undergo [3]
-Prevents intracellular killing of gonococci within neutrophils by
preventing [4]
-Responsible for variable resistance of gonococci to killing by normal human serum by selectively binding to [5], therefore prevents [6]of the organism
- Protein I (Por proteins)
- porins
- antigenic variation
- phagosome–lysosome fusion
- complement components
- complement-mediated lysis
Outer Membrane Proteins (OM Proteins)
[1]
-A portion is in the [2], and the rest is exposed on the cell surface.
-Undergo antigenic variation.
-Functions in the [3] of gonococci within colonies and attachment of gonococci to host cell receptors
- Protein II (Opa proteins)
- gonococcal outer membrane
- adhesion
