Gonorrhea

•       Sexually transmitted disease

•       Caused by organism Neisseria gonorrhoeae

•       Gram-negative intracellular diplococcus

•       Infects mucus-secreting epithelial cells

Transmission of gonorrhea

•       Efficiently transmitted by:

•       Male to female via semen

•       Female to male urethra

•       Rectal intercourse

•       Fellatio (pharyngeal infection)

•       Perinatal transmission (mother to infant)

•       Gonorrhea associated with increased transmission of and susceptibility to HIV infection

Pathophysiology of gonorrhea

•       Contact with a mucosal surface lined by columnar, cuboidal, or noncornified squamous epithelial cells

•       The gonococci attach to cell membranes by means of surface pili and are then pinocytosed

•       Virulence of the organism is mediated primarily by the presence of pili and other outer membrane proteins.

•       After mucosal damage is established, polymorphonuclear (pmn) leukocytes invade the tissue,submucosal abscesses form, and purulent exudates are secreted

Clinical manifestations of gonorrhea

•       In males

•       Can be asymptomatic or minimally symptomatic

•       Urethral infection—dysuria and urinary frequency

•       Anorectal infection—asymptomatic to severe rectal

•       Pharyngeal infection—asymptomatic to mild pharyngitis

•       In females

•       Can be asymptomatic or minimally symptomatic

•       Endocervical infection—usually asymptomatic or mildly symptomatic

•       Urethral infection—dysuria, urinary frequency

•       Anorectal and pharyngeal infection—symptoms same as for men

Summary

•       Gonorrhea – sexually transmitted disease

•       Causative agent – Neisseria gonorrhoeae

•       Infects mucus-secreting epithelial cells

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Pathophysiology Notes