Presentation
Only four genes - encoding hypothetical proteins - are present in all commensals, while several are present in one or more commensals. [doi.org]
Author information 1 1Wadsworth Center, Bacteriology Laboratory, New York State Department of Health, PO Box 22002, Albany, NY 12201, USA. 2 ‡Present address: Wadsworth Center, Virology Laboratory, New York State Department of Health, PO Box 22002, Albany [ncbi.nlm.nih.gov]
The discharge may present at the meatus, which may be erythematous. Discharge may be expressed by milking the penis. N. gonorrhoeae may also cause epididymitis, which can present as unilateral testicular pain without discharge or dysuria. [aafp.org]
Entire Body System
- Inflammation
FACTS: Meningitis is technically an inflammation of the meninges, or the membranes covering the brain and spinal cord. It can be extremely dangerous. [giantmicrobes.com]
In men, untreated gonorrhoea infection can cause epididymitis, an inflammation of the male reproductive tubes. Lisää A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Ä Ö 0-9 [fi.bab.la]
Infection with viral pathogens, such as influenza, leads to inflammation in the nasopharynx with an increased temperature and recruitment of immune effectors 3, 4. [nature.com]
Mechanism of pathogenesis: Gonococci adhere to epithelial cells of urethra or other mucosal surface through pili penetrate through the intercellular space reach the sub epithelial connective tissue & causes inflammation Leads to clinical manifestations [de.slideshare.net]
- Weakness
[…] biovar perflava Diplococci + + + + – – + Weak (2+) positive (R) N. sicca Diplococci + + + + – – + Weak (2+) positive S N. mucosa Diplococci + + + + – + + Weak (2+) positive S N. flavescens Diplococci – – – – – – + Weak (2+) positive S N. elongata Rod [cdc.gov]
Patients with meningococcal sepsis (severe illness caused by bacteria or their toxins in the blood) may present with high fever, hypotension (low blood pressure), and profound weakness. [dph.georgia.gov]
This includes a high fever, weakness, or signs of an allergic reaction, such as trouble breathing, a fast heartbeat, or dizziness . [webmd.com]
- Malaise
We report the case of a 56-year-old Caucasian woman who was admitted to hospital with a 5-week history of fever, malaise and fatigue. [ncbi.nlm.nih.gov]
CLINICAL FEATURES Febrile illness : Mild and self limiting Pyogenic meningitis : High fever, stiff neck, Kernig’s sign, severe headache, vomiting, photophobia, chills Meningococcemia : acute fever with chills, malaise, prostation, Waterhouse- frederichsen [de.slideshare.net]
Acute infection is usually preceded by fever, chills, and general malaise. The tenosynovitis usually involves multiple small joints, such as the wrists, fingers, ankles, and toes. [cancertherapyadvisor.com]
Cases typically experience acute fever, malaise, nausea, myalgia, arthralgia and prostration. A rash occurs in about two-thirds of cases – this may be ill defined and macular, petechial or purpuric. [health.govt.nz]
Fever, malaise, lassitude, nausea, shivers, tachycardia, and mild headache are all common early features ( 65 ). [antimicrobe.org]
- Infertility
Complications in females Tubal scarring and infertility are the major complications of gonococcal infection in females. [emedicine.medscape.com]
PID can negatively affect fertility, causing infertility in 15 percent of patients 2 ; 50 percent of patients who have three or more episodes of PID develop infertility. 2 The Centers for Disease Control and Prevention (CDC) recommends that physicians [aafp.org]
Untreated infection in women may cause pelvic inflammatory disease and possible infertility due to the resulting scarring. [8] Diagnosis is through culture, Gram stain, or polymerase chain reaction testing of a urine sample, urethral swab, or cervical [en.wikipedia.org]
N. gonorrhoeae infections can lead to heart and nervous system infections, infertility, ectopic pregnancies, newborn blindness, and increased risk for other sexually transmitted infections, including HIV 3. [nature.com]
- Military Personnel
It is quite contagious, and often spreads through groups of close quartered individuals such as children in daycare-settings, college students, and military personnel. [giantmicrobes.com]
Gastrointestinal
- Vomiting
Other symptoms may include nausea, vomiting, increased sensitivity to light, and confusion. Children and infants may show different signs and symptoms, such as inactivity, irritability, vomiting, or poor reflexes. [wwwnc.cdc.gov]
The most frequent symptoms are fever, headache, vomiting, stiff neck, confusion or coma for meningitis and fever, petechial rash or purpuric lesions and shock for meningococcal septicaemia. [bacterio.wiv-isp.be]
[…] serogroups - 13 recognized groups (Groups A, B, C, X, Y, Z and W135 are frequently occurring); infection of the CSF SECTION II - HEALTH HAZARD PATHOGENICITY: Acute disease characterized by sudden onset with fever, intense headache, nausea and often vomiting [msdsonline.com]
The more common signs and symptoms include: General poor feeling Sudden high fever Severe, persistent headache Neck stiffness Nausea or vomiting Discomfort in bright lights Drowsiness or difficulty awakening Joint pain Confusion or other mental changes [webmd.com]
- Nausea
The signature symptoms of meningitis include a severe headache and stiff neck – which, in extreme cases, can cause sufferers to arch backwards – as well as fevers and chills, nausea, sensitivity to light and sound, and sometimes purple or red splotches [giantmicrobes.com]
(8-9%) 1-10% Trumenba Vomiting (2.5-7.4%) Fever ≥38°C (1.1-6.4%) Bexsero Fever,≥38°C (1-5%) Moderate severity Headache (6-9%) Nausea (4-5%) Erythema, >50-100mm (3-5%) Fever, 38-38.9°C (1-4%) Arthralgia (2%) Induration, >50-100mm (1-2%) Severe severity [reference.medscape.com]
Other symptoms may include nausea, vomiting, increased sensitivity to light, and confusion. Children and infants may show different signs and symptoms, such as inactivity, irritability, vomiting, or poor reflexes. [wwwnc.cdc.gov]
[…] extra-cellular; multiple serogroups - 13 recognized groups (Groups A, B, C, X, Y, Z and W135 are frequently occurring); infection of the CSF SECTION II - HEALTH HAZARD PATHOGENICITY: Acute disease characterized by sudden onset with fever, intense headache, nausea [msdsonline.com]
Cardiovascular
- Hypotension
Patients with meningococcal sepsis (severe illness caused by bacteria or their toxins in the blood) may present with high fever, hypotension (low blood pressure), and profound weakness. [dph.georgia.gov]
[…] disease. [8] Clinical features Symptoms of meningitis can develop very quickly and require prompt medical attention to increase the probability of recovery. [11] Characteristics of meningitis include acute onset of fever, severe headache, weakness, hypotension [microbewiki.kenyon.edu]
profound shock, high fever, pulmonary insufficiency Meningococcal septicemia: Fever, rash, tachycardia, hypotension, cool extremities, initially normal level of consciousness See Clinical Presentation for more detail. [emedicine.medscape.com]
- Thrombosis
Purpura fulminans (hemorrhagic condition resulting in tissue necrosis and small vessel thrombosis) can result in scarring or limb amputations. Approximately 10-14% of cases of meningococcal disease are fatal. [dph.georgia.gov]
Reduced cerebral blood flow with vasculitis and thrombosis of cerebral vessels may cause ischemia and neuronal injury. [emedicine.medscape.com]
- Acrocyanosis
More severe infection leads to shock, disseminated intra-vascular coagulation (DIC), acrocyanosis and multi-organ failure. [health.govt.nz]
Eyes
- Photophobia
CLINICAL FEATURES Febrile illness : Mild and self limiting Pyogenic meningitis : High fever, stiff neck, Kernig’s sign, severe headache, vomiting, photophobia, chills Meningococcemia : acute fever with chills, malaise, prostation, Waterhouse- frederichsen [de.slideshare.net]
Meningococcemia : Patients present with rapid onset of fever, vomiting, photophobia, convulsions, skin rash, lethargy, irritability, drowsiness, diarrhea, muscular pain, arthralgia, and rarely, acute abdominal pain Footnote 3. [phac-aspc.gc.ca]
Approximately 75 percent of cases with invasive disease have meningitis (typically causing headache, photophobia and neck stiffness). Infants present with less-specific features. [health.govt.nz]
In addition, these symptoms are often accompanied by stiff neck, photophobia, and altered mental status. [microbewiki.kenyon.edu]
Skin
- Petechiae
In either case, patients may develop a characteristic rash including petechiae (pinpoint red spots that do not blanch with pressure) or purpura (purple areas similar to bruises) that are caused by bleeding into the skin. [dph.georgia.gov]
Rapid detection of meningococci from petechiae in acute meningococcal infection. J Infect. 1995 Nov. 31(3):201-3. [Medline]. Arend SM, Lavrijsen AP, Kuijken I, van der Plas RN, Kuijper EJ. [emedicine.medscape.com]
These legions start as papules and progress into bullae, petechiae, and necrotic lesions. The most commonly infected joints include wrists, ankles, and the joints of the hands and feet. [aafp.org]
- Eruptions
In fulminant meningococcemia, a hemorrhagic eruption, hypotension, and cardiac depression, as well as rapid enlargement of petechiae and purpuric lesions (see the image below) Child with severe meningococcal disease and purpura fulminans. [emedicine.medscape.com]
Musculoskeletal
- Arthritis
Patients with disseminated gonococcal infection will usually present with either a triad of tenosynovitis, dermatitis, and polyarthralgias without purulent arthritis or purulent arthritis without associated skin lesions. [cancertherapyadvisor.com]
Septic arthritis, courtesy of CDC PHIL, # 6805 Disseminated gonococcal infection (DGI) may also spread via the bloodstream, causing bacteremia/sepsis, rash (petechial, maculopapular, or pustular), septic arthritis, meningitis, or endocarditis. return [sharinginhealth.ca]
C) In both the sexes: Proctitis, pharyngitis, conjunctivitis, bacteraemia which may lead to metastatic infection such as arthritis, endocarditis, meningitis, pyemia & skin rashes. [de.slideshare.net]
Arthritis Gonorrhea is the most common cause of arthritis in the adolescent. However, arthritis (septic or reactive) is a rare complication of this disease. [emedicine.medscape.com]
Silver nitrate is no longer used in the United States. [35] [32] Disseminated gonococcal infections can occur when N. gonorrhoeae enters the bloodstream, often spreading to the joints and causing a rash (dermatitis-arthritis syndrome). [32] Dermatitis-arthritis [en.wikipedia.org]
- Myalgia
A 31-year-old Argentinian woman presented with a 3-week history of fever, night sweats, myalgia and lethargy following a work trip to Uganda where she ran a marathon. [ncbi.nlm.nih.gov]
severe (12-13%) Pain, severe (20-29%) Any severity Pain (83-90%) Erythema (45-50%) Myalgia (48-49%) Fatigue (35-37%) Headache (33-34%) nduration (28-32%) Nausea (18-19%) Arthralgia (13-16%) Moderate severity Pain (37-44%) Myalgia (16-19%) Fatigue (10 [reference.medscape.com]
History Part I: Pattern Recognition: A typical patient with meningococcal meningitis will present with the sudden onset of fever, nausea and vomiting, headache, trouble focusing, and myalgias. [cancertherapyadvisor.com]
Cases typically experience acute fever, malaise, nausea, myalgia, arthralgia and prostration. A rash occurs in about two-thirds of cases – this may be ill defined and macular, petechial or purpuric. [health.govt.nz]
[…] presentation of meningococcemia may include any of the following: A nonspecific prodrome of cough, headache, and sore throat The above followed by a few days of upper respiratory symptoms, increasing temperature, and chills Subsequent malaise, weakness, myalgias [emedicine.medscape.com]
Neurologic
- Headache
Meningitis can be a real headache – and a pain in the neck too. Learn how to stay clear of this fathead. Great for medical professionals and health care experts. [giantmicrobes.com]
—A 35-year-old man was hospitalized with a two-week history of headaches, fever, and chills. The patient had a history of recurrent dental abscesses. Four months before admission, he had dental work performed without antibiotic prophylaxis. [jamanetwork.com]
Nausea (18-19%) Arthralgia (13-16%) Moderate severity Pain (37-44%) Myalgia (16-19%) Fatigue (10-14%) Mild severity Erythema,1-25 mm (36-41%) Pain (18-27%) Induration,1-25 mm (22-24%) Fatigue (18-19%) Headache (19-21%) Myalgia (16-21%) Nausea (10-12% [reference.medscape.com]
The most frequent symptoms are fever, headache, vomiting, stiff neck, confusion or coma for meningitis and fever, petechial rash or purpuric lesions and shock for meningococcal septicaemia. [bacterio.wiv-isp.be]
- Neck Stiffness
The more common signs and symptoms include: General poor feeling Sudden high fever Severe, persistent headache Neck stiffness Nausea or vomiting Discomfort in bright lights Drowsiness or difficulty awakening Joint pain Confusion or other mental changes [webmd.com]
Footnote 3 : Most patients also present with signs of meningeal irritation, including, neck stiffness, bulging fontanelle (in infants), irritability, lying on one side away from light, and inability to extend the knee when hip is flexed in supine position [phac-aspc.gc.ca]
Approximately 75 percent of cases with invasive disease have meningitis (typically causing headache, photophobia and neck stiffness). Infants present with less-specific features. [health.govt.nz]
- Confusion
There is a paucity of information on N. weaveri within the literature and historically there has been confusion with its taxonomy, with two different type strains being described ( 1 – 3 ). [doi.org]
The most frequent symptoms are fever, headache, vomiting, stiff neck, confusion or coma for meningitis and fever, petechial rash or purpuric lesions and shock for meningococcal septicaemia. [bacterio.wiv-isp.be]
Other symptoms may include nausea, vomiting, increased sensitivity to light, and confusion. Children and infants may show different signs and symptoms, such as inactivity, irritability, vomiting, or poor reflexes. [wwwnc.cdc.gov]
Meningococcal meningitis can be confused with other causes of bacterial meningitis, viral meningitis, encephalitis, Human Immunodeficiency Virus (HIV) seroconversion, pharyngitis, influenza infection, and any other viral prodrome. [cancertherapyadvisor.com]
The more common signs and symptoms include: General poor feeling Sudden high fever Severe, persistent headache Neck stiffness Nausea or vomiting Discomfort in bright lights Drowsiness or difficulty awakening Joint pain Confusion or other mental changes [webmd.com]
Workup
For patients with recurrent Neisseria, consider outpatient workup for complement deficiency and make sure resistance testing is being done on cultures. IV. Management with Co-Morbidities. A. Renal Insufficiency. [cancertherapyadvisor.com]
(See Pathophysiology, Prognosis, Presentation, and Workup.) Gonococcal infections following sexual and perinatal transmission are a major source of morbidity worldwide. [emedicine.medscape.com]
Microbiology
- Chlamydia
METHODS: We developed the 'Chlamy and Ness CT/NG kit' based on molecular beacons for the detection of Chlamydia trachomatis (CT) and Neisseriagonorrhoeae (NG). [ncbi.nlm.nih.gov]
Digene also marketed its hybrid capture assay for Chlamydia and Neisseria. [labce.com]
Other modules will focus on treatments for Chlamydia trachomatis (chlamydia), herpes simplex virus type 2 (HSV-2; genital herpes) and Treponema pallidum (syphilis). [who.int]
Crotchfelt KA, Pare B, Gaydos C, Quinn TC: Detection of Chlamydia trachomatis by the GEN-PROBE AMPLIFIED Chlamydia trachomatis Assay (AMP CT) in urine specimens from men and women and endocervical specimens from women. [mayomedicallaboratories.com]
- Chlamydia Trachomatis
Other modules will focus on treatments for Chlamydia trachomatis (chlamydia), herpes simplex virus type 2 (HSV-2; genital herpes) and Treponema pallidum (syphilis). [who.int]
Crotchfelt KA, Pare B, Gaydos C, Quinn TC: Detection of Chlamydia trachomatis by the GEN-PROBE AMPLIFIED Chlamydia trachomatis Assay (AMP CT) in urine specimens from men and women and endocervical specimens from women. [mayomedicallaboratories.com]
METHODS: We developed the 'Chlamy and Ness CT/NG kit' based on molecular beacons for the detection of Chlamydia trachomatis (CT) and Neisseriagonorrhoeae (NG). [ncbi.nlm.nih.gov]
Evaluation of the Cobas 4800 CT/NG test for detecting Chlamydia trachomatis and Neisseria gonorrhoeae. Sex Transm Infect 86 : 470 – 473. 79. [asmscience.org]
- Herpes Simplex Virus Type 2
Other modules will focus on treatments for Chlamydia trachomatis (chlamydia), herpes simplex virus type 2 (HSV-2; genital herpes) and Treponema pallidum (syphilis). [who.int]
Treatment
[…] countries have reported treatment failures. [who.int]
In 1997 Young et al reported a case of azithromycin treatment failure with characterisation of the pre- and post-treatment isolate. [sti.bmj.com]
No studies of the treatment of DGI have been published in the past 24 years. The CDC recommendations for the treatment of DGI are based on the opinions of experts. [antimicrobe.org]
Prognosis
Prognosis and Patient Counseling. [cancertherapyadvisor.com]
(See Pathophysiology, Etiology, and Prognosis, and Treatment.) [emedicine.medscape.com]
The bacteria live on these implants in biofilms and the infection can jeopardize the prognosis of the patient. N. gonorrhoeae can colonize intrauterine devices in a mixed biofilm with other bacteria as described previously [ 14 ]. [ncbi.nlm.nih.gov]
Etiology
Neisseria /Neis·se·ria/ ( ni-sēr´e-ah ) a genus of gram-negative bacteria (family Neisseriaceae), including N. gonorrhoe´ae, the etiologic agent of gonorrhea, N. meningi´tidis, a prominent cause of meningitis and the specific etiologic agent of meningococcal [medical-dictionary.thefreedictionary.com]
Bacterial Meningitis/Sepsis Case Investigation(Worksheet A) Identifying Close Contacts for the Prevention of Secondary Meningococcal Disease Cases (Worksheet B) Contact Exposure Follow-Up Worksheet (Worksheet C) Suggestive Patterns for Discerning the Etiology [dph.georgia.gov]
Etiology: a) Bacteria- Chlamydia trachomatis Mycoplasma urealyticum Ureaplasma urealyticum b) Parasites- Trichomonas vaginalis c) Viruses- Herpes simplex Cytomegalovirus d) Fungi- Candida NGU can be a part of Reiter’s syndrome- a clinical condition [de.slideshare.net]
From: Bioquell.com [2] Etiology/Bacteriology Taxonomy | Domain = Prokaryote | Phylum = Proteobacteria | Class = Betaproteobacteria | Order = Neisseriales | Family = Neisseriaceae | Genus = Neisseria | species = Neisseria meningitidis Description Neisseria [microbewiki.kenyon.edu]
(See Pathophysiology, Etiology, and Prognosis, and Treatment.) [emedicine.medscape.com]
Epidemiology
The molecular epidemiological characteristics of the isolates were determined by Sanger sequencing of bla(TEM), N. gonorrhoeae multiantigen sequence typing (NG-MAST) and plasmid typing. [ncbi.nlm.nih.gov]
Overview Rationale for the guidelines Since the publication of the WHO Guidelines for the management of sexually transmitted infections in 2003, changes in the epidemiology of STIs and advancements in prevention, diagnosis and treatment necessitate changes [who.int]
Pathophysiology
We also review the pertinent literature and discuss available evidence on pathophysiological mechanisms of infection with such commensal bacteria. [ncbi.nlm.nih.gov]
(See Pathophysiology, Etiology, and Prognosis, and Treatment.) [emedicine.medscape.com]
“Disseminated gonococcal infection: a prospective analysis of 49 patients and a review of pathophysiology and immune mechanisms”. Medicine (Baltimore). vol. 62. 1983. pp. 395 Rice, PA. “Gonococcal arthritis (disseminated gonococcal infection)”. [cancertherapyadvisor.com]
Prevention
Author information 1 Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, FIOCRUZ-BAHIA, Rua Waldemar Falcão 121, 40296-710, Salvador BA, Brazil. 2 Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, [ncbi.nlm.nih.gov]
Prevention General Meningococcal disease prevention advice includes maintaining good overall health, avoiding first and second-hand tobacco smoke, using cough etiquette, and minimizing shared saliva. [dph.georgia.gov]
That's why prevention is a far better approach. The meningococcal vaccine can prevent meningitis infection. [webmd.com]
and the Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta (S.B.). [nejm.org]
In addition, future work will provide guidance for syphilis screening and treatment of pregnant women, STI syndromic approach, clinical management, STI prevention, and treatments for other STIs. [who.int]