N.gonorrhea

Question 1

virulence factors

Answer 1

1.pili-for attachemment to the epithelial cells of the urogenital tract and slow phagocytosis. 2.outer membrane porin-presents fusion of phagosome and lysosome resulting in survival inside phagocytes. 3.generates serum resistance-Has modified LPS that prevents the proper formation of the membrane attack complex during complement cascade. 4.genetic variation-in its pili.antibodies produced are useless agianst the new pili and adherence to host tissue occurs. 5.Produces IgA proteases that destroy secretory IgA and allow adherence.

Question 2

Pathogenesis

Answer 2

Transmission through sexual intercourse.N.gonnorhea is sensitive to drying so intimate transmission directly to a suitable mucous membrane is required. Vertical transmission from mother to baby during child birth. portal of entry is genital or extragenital. After attaching to the epithelial surface of the vahina or penis by pili the bacteria invade the underlying connective tissue. pili and other adherence factors prevent the bactria from being washed away by urine or vaginal discharges. The pathogen rapidly multiplies and spreads through the cervix in women and up the urethra in males. This process results in an inflammatory reaction that may or may not be symptomatic.

Question 3

Males

Answer 3

urethritis-painful urination and yellowish discharge. scar tissue formed in the spermatic duct during healing can rendr the individual infertile.

Question 4

females

Answer 4

proximity of the genital and urinary tract openings increases the likelihood that both systems can be infected during sexual intercourse.

Question 5

complications

Answer 5

pelvic inflammatory disease.(salpingitis) chronic pelvic pain. infertility resulting from damage to the fallopian tubes

Question 6

Extragenital gonococcal infections

Answer 6

Anal intercourse-proctitis oral copulation-pharyngitis and gingivitis -mostly homisexuals careless personal hygiene -self inoculation of the eyes causing conjuctivitis. The bacteria can enter the bloodstream and is desiminated to joints and skin .involvement of wrisk and ankle can kead to athritis . gonococcal bacteremia-meningitis,endocarditis.

Question 7

gonococcal infection in children

Answer 7

gonococcal eye infections-keratitis,opthalmia neonatorum and blindness.

Question 8

clinical diagnosis

Answer 8

1.microscopy and culture of appropriate spcimens. 2.Gram staining-G-,intracellular diplococci in smear of urethral,vaginal ,cervical or eye exudates. 3.growth of N.gonorrhea in culture to determine oxidase reaction. 4.culture should be made on warm selectivr media becsuse it is sensitive to drying. Blood cultures collected if disseminated disease is suspected. commercial kits with probes specific for N.gonorrhea DNA are available.