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29 Cards in this Set

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Neisseria is the only pathogenic bacteria that is?

Gram-negative cocci, and more precise diplococci
Neiseria meningitidis virulence factors include?
Endotoxin (LPS) (petechiae and sepsis); IgA protease (cleaves IgA); pili (undergoes antigenic variation); leeches iron; capsule (antiphagocytic)
What are the high risk groups for infection with N. meningitidis?
Infants aged 6 months - 2 years (infants will not manufacture ABs for a few years); and army recruits.
N. meningitidis usually spreads?
Via respiratory secretions
N. meningitidis can live asymptomatically in?
Nasopharynx epithelium
N. meningitids can cause?
Waterhouse-Friderischsen syndrome; meningococcemia with petechial rash; and meningitis
Most common form of N. meningitidis?
Meningitis, usually striking infants less than one year of age.
What is meningococcemia?
Intravascular multiplication of N. meningitidis resulting in spiking fevers, chills, arthralgia, muscle pain, and petechial rash.
How do you diagnosis N. meningitidis?
Gram stain of culture from blood, CSF, or petechial scrapings.
What blood agar does N. meningitidis grow on?
Thayer-Martin VPN. Blood agar that is heated (turns brown, AKA chocolate agar). V (vancomycin--kills gram positive); P (polymyxin--kills all gram negative other than Neisseria; and N (nystatin--which eliminates fungi).
How can you differentiate between the two Neisseria in culture?
N. meningitidis produces acid from maltose metabolism while N. gonorrhoeae cannot
How do you treat N. meningitids?
Penicillin G or ceftriaxone. Close contacts with infected PT are treated with rifampin for prophylaxis.
What are the virulence factors for Neisseria gonorrhoeae?
Pili (hypervariable a.a. sequences "phase variation"; prevents phagocytosis); protein I (promote invasion into epithelial cells); opa proteins (adherence and invasion into epithelial cells); and gonococcal endotoxin (LPS) (destroys cilia on neighboring cells, allowing the gonoccus to be taken up by endocytosis); and IgA protease

Nath also has: Gonococcal OMPs (e.g., protein I) that protects against phagocytosis and protein I interferes with neutrophil degranulation. Cell-wall lipo-oligosaccharide (LOS) and OMP contribute to virulence. OMP = outer membrane proteins.
N. gonorrhoeae in men? And what are some possible complications?
Urethritis, painful urination with purulent urethral discharge. Possible complications include: epididymitis, prostatitis, and urethral strictures. There can also be rectal gonococcal infection with anal pruritis, tenesmus, and/or rectal bleeding and purulent discharge.
N. gonorrhoeae in women?
Urethritis (most likely asymptomatic), painful burning minimal urethral discharge, cervicitis with purulent exudate, lower abdominal discomfort, painful intercourse (dyspareunia).
What are some possible complications from N. gonorrhoeae in women?
Infection to the cervix can produce pelvic inflammatory disease: infection in the uterus (endometritis), fallopian tubes (salpingitis), and/or ovaries (oophoritis). PTs may present with abnormal menstrual bleeding, cervical motion tenderness.
What increases the risk of pelvic inflammatory disease?
Menstruation (allows bacteria to spread to cervix, and often symptomatic within one week after menstruation) and presence of of an intrauterine device.
What are complications of pelvic inflammatory disease?
Sterility (scaring of fallopian tubes); ectopic pregnancy (scaring of fallopian tubes); abscesses; peritoniitis; and Fitz-Hugh-Curtis syndrome (infection of the liver capsule)
Rarely, N. gonococcal will invade the blood stream. If so, what happens?
May collect in the synovial fluid, and cause septic arthritis. This is the most common cause of septic arthritis in sexually active people.
What does N. gonococcal grow on?
Thayer-Martin media
How do you treat N. gonorrhoeae?
Ceftriaxone (+ doxycycline or azithromycin for probable concurrent Chlamydia infection)
In neonates, what can N. gonorrhoeae cause?
Opthalmia neonatorum, a risk for blindness.
Moraxella catarrhalis can cause?
Otitis media and upper respiratory infection in PTs with COPD or in the elderly.
Kingella kingae can cause?
Frequently colonizes the throat of the young and cause septic arthritis and osteomyelitis in children. In children and adults, can cause endocarditis of native and prosthetic valves.
How do you diagnosis N. gonorrhoeae?
Multiple pairs of bean-shaped, Gram-negative diplococci within a neutrophil in a Gram smear of urethral discharge.
N. gonorrhoeae do not have?
A polysaccharide capsule, but a pili. This prevents phagocytosis.

They have a capsule.
All Neisseria are?
Oxidase positive
How do you tell Neisseria gonorrhoeae from N. meningitidis?
Gonorrhoeae is glucose oxidizer only.

Meningitids is maltose and glucose oxidizer.
N. gonorrhoeae is strictly a?
Human pathogen, with asymptomatic carriers being the largest reservoir.