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Chapter 8: Neisseria


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What shape are Neisseria?
Small kidney-bean diplococci - looks like a small donut
What are the important virulence factors of the meningococcus?
Polysaccharide capsule, endotoxin (LPS), IgA1 protease
What are the high risk groups for Neisseria meningitides infection?
- Infants aged 6 months to 2 years
- army recruits / dorm students
What are the manifestations of meningococcal disease? What is the classic 'clue' to an invasive meningococcal infection?
- Meningococcemia: spiking fevers, arthralgia, and muscle pains
- fulminant meningococcemia (Waterhouse-Friderichsen syndrome) septic shock
- meningitis
What is the classic medium for culturing Neisseria?
Thayer-Martin VCN media
Prompt treatment with what is required at the first indication of disseminated meningococcemia?
Penicillin G or ceftriaxone
What are the two most common sexually transmitted diseases?
Describe gonococcal disease in women?
Urethritis - often asymptomatic, with minimal discharge. Infection of the cervix, which becomes reddened with a purulent exudate. Can progress to PID.
What are the complications of pelvic inflammatory disease (PID)?
Sterility, ectopic pregnancy, abscesses, peritonitis, peri-hepatitis (infection of the capsule that surrounds the liver).
What are the manifestations of gonococcal bacteremia?
Fever, joint pains, skin lesions. More rare - pericarditis, endocarditis, and meningitis.
What is the most common kind of septic arthritis in young, sexually active individuals?
Gonococcal arthritis
What is ophthalmia neonatorum and how is it treated?
Transmission of N. gonorrhoeae to a neonate during delivery, resulting in an eye infection. Treat with erythromycin (which also covers Chlamydia)
If a patient is diagnosed with Neisseria gonorrhoeae infection, what is the treatment standard and why?
Ceftriaxonde (3rd gen cephalosporin), which will also treat syphilis. At the same time, treat with doxycycline or azithromycin for Chlamydia trachomatic (a beta-lactam resistant bug that concurrently infects 50% of gonorrhea patients)
Branhamella catarrhalis causes disease of which organ tract?
Respiratory tract, otitis media, sinusisits, bronchitis, and pneumonia.

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