Gonorrhea

Gonorrhea

Transmission, Pathophysiology, Clinical manifestations of 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

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