Neisseria gonorrhea (STI) symptoms, pathophysiology, complications and treatment

Summary

Neisseria gonorrhoeae is a gram-negative bacteria responsible for gonorrhea, a common sexually transmitted infection. It infects the urogenital tract, causing symptoms like dysuria, discharge, and abdominal pain. The bacterium can evade the immune system using various virulence factors, leading to severe complications such as pelvic inflammatory disease, endocarditis, and arthritis. Gonorrhea can also be transmitted to infants during childbirth, causing eye infections. Diagnosis is typically done via nucleic acid amplification tests, and treatment involves antibiotics like ceftriaxone. Safe sexual practices and prompt treatment are essential for preventing the spread of this infection.

Takeaways

• 😀 Nisseria gonorrhea is a gram-negative diplococci bacterium responsible for gonorrhea, a common sexually transmitted infection.
• 😀 Gonorrhea is the second most common bacterial STI globally, after chlamydia, and its rates have been rising due to antibiotic resistance.
• 😀 The bacterium's cell envelope includes an inner membrane, a peptidoglycan layer, and an outer membrane with lipooligosaccharides (LOS), contributing to its virulence.
• 😀 Nisseria gonorrhea uses pili, proteins, and opacity proteins (Opa) to adhere to and invade epithelial cells in the body.
• 😀 The bacteria are primarily transmitted through sexual contact (oral, genital, or anal), and perinatal transmission is also possible.
• 😀 Key risk factors for gonorrhea infection include age (20-29), multiple sexual partners, unprotected sex, and prior STIs.
• 😀 Gonorrhea causes inflammation in the urogenital tract, leading to conditions like urethritis, epididymitis, and prostatitis in men.
• 😀 In women, gonorrhea can cause pelvic inflammatory disease, endometritis, salpingitis, and complications like infertility and ectopic pregnancy.
• 😀 If left untreated, gonorrhea can spread to other parts of the body, including the liver and joints, causing severe complications such as Fitz-Hugh-Curtis syndrome.
• 😀 Diagnosis of gonorrhea is typically done through nucleic acid amplification tests (NAATs), bacterial cultures, and sometimes blood tests.
• 😀 Treatment involves antibiotics like ceftriaxone, often paired with azithromycin or doxycycline. Sexual activity should be avoided for 7 days after treatment, and sexual partners should also be tested and treated.

Q & A

What is N. gonorrhea, and what infection does it cause?

N. gonorrhea, or Neisseria gonorrhoeae, is a gram-negative, diplococci bacterium that causes gonorrhea, a sexually transmitted infection (STI). If left untreated, gonorrhea can lead to serious complications such as septic arthritis and pelvic inflammatory disease.

What makes Neisseria gonorrhoeae a significant concern in public health?

Neisseria gonorrhoeae is a significant concern due to its high prevalence as the second most common bacterial STI worldwide and its increasing antibiotic resistance, making treatment more challenging.

What is the structure of Neisseria gonorrhoeae and its components?

Neisseria gonorrhoeae is a gram-negative bacterium with a cell envelope consisting of an inner cytoplasmic membrane, a middle layer of peptidoglycan, and an outer membrane. The outer membrane contains lipooligosaccharides (LOS), phospholipids, and proteins that contribute to cell adherence, tissue invasion, and resistance to immune defenses.

How does Neisseria gonorrhoeae adhere to host cells?

Neisseria gonorrhoeae adheres to host cells using pili, which are dynamic polymeric protein filaments. Additionally, it uses opacity proteins (Opa proteins) to further facilitate cell adhesion.

What are the primary modes of transmission for N. gonorrhoeae?

N. gonorrhoeae is primarily transmitted through sexual contact, including oral, genital, and anal routes. It can also be transmitted perinatally from mother to infant during childbirth.

What are some common risk factors for gonorrhea infection?

Risk factors for gonorrhea infection include being aged 20-29, having multiple sexual partners, engaging in unprotected sex, having known partners with gonorrhea, men who have sex with men, and a current or prior history of sexually transmitted infections.

What are the key virulence factors of Neisseria gonorrhoeae?

Key virulence factors of Neisseria gonorrhoeae include lipooligosaccharides (LOS) that act as an endotoxin, IGA proteases that inactivate host immunoglobulins, a capsule that helps evade phagocytosis, and porin proteins that aid in immune system evasion.

What complications can arise from untreated gonorrhea in men and women?

In men, untreated gonorrhea can cause urethritis, epididymitis, and prostatitis, often resulting in dysuria, discharge, and abdominal discomfort. In women, gonorrhea can lead to pelvic inflammatory disease (PID), which may cause infertility, chronic pelvic pain, and ectopic pregnancy. Additionally, gonorrhea can spread to the liver or joints, causing further complications.

What is disseminated gonococcal infection (DGI), and what are its symptoms?

Disseminated gonococcal infection (DGI) occurs when Neisseria gonorrhoeae spreads through the bloodstream, causing symptoms such as hemorrhagic vesicopustular eruptions, polyarthralgia (joint pain), and tenosynovitis (inflammation of the tendon sheath).

How is gonorrhea diagnosed and what tests are commonly used?

Gonorrhea is typically diagnosed through nucleic acid amplification tests (NAATs), which can be performed on urine, urethral, or cervical discharge. Bacterial cultures from the cervix, blood, or pharynx can also be used for diagnosis, particularly in cases of disseminated infection.

What is the recommended treatment for gonorrhea?

The recommended treatment for gonorrhea is ceftriaxone, often combined with azithromycin or doxycycline. It is important for patients to refrain from sexual contact for at least seven days after starting treatment, and sexual partners from the last two months should be tested and treated if necessary.