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Meningo, Gono, Cocci

Meningo, Gono, Cocci. Professor Sudheer Kher. Neisseria. Neisseria meningitidis. Neisseria gonorrhoeae. N meningitidis. Gram negative cocci in pairs. Flat adjacent sides. Capsulated. 13 serogroups. A , B, C , D, X, Y , Z, W-135 , 29 E, H, I, K & L.

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Meningo, Gono, Cocci

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  1. Meningo, Gono, Cocci Professor Sudheer Kher

  2. Neisseria Neisseria meningitidis Neisseria gonorrhoeae

  3. N meningitidis Gram negative cocci in pairs Flat adjacent sides Capsulated 13 serogroups A, B, C, D, X, Y, Z, W-135, 29 E, H, I, K & L Most epidemic is due to serogroup A

  4. How man acquire infection ? Source Nasopharyngeal Carriers (5-10%) Mode of transmission Inhalation Infection An increase in carrier rate heralds onset of epidemic Disease Meningitis and Septicemia Pathogenicity Cribriform plate Nasopharynx Perineural sheath Subarachnoid space Olfactory nerve Blood stream

  5. Laboratory Diagnosis Specimens CSF, blood, NP swab, petechial lesions Gram negative cocci in pairs, capsulated Microscopy Gram stain Culture Chocolate agar: Translucent colonies Selective media Modified Thayer Martin (Vanco + Colistin + Nystatin) Identification tests Oxidase + Catalase + Glucosefermentation Maltose fermentation Antibiotic susceptibility test Penicillin, Cefotaxime, Ceftriaxone, Vancomycin

  6. Treatment 3rd GC Ceftriaxone, cefotaxime Vaccines Capsular vaccine for serogroups A, C, W, & Y Routinely used in military During outbreak in civilian population Prophylaxis Rifampin (eliminate carrier state) Used to treat faily members of an infected individual

  7. N gonorrhoeae Gram negative cocci in pairs Resembles a pair of kidney beans Non capsulated Source Vaginal Carriers Patients Mode of transmission Sexual

  8. Virulence factors N gonorrhoeae Pili Lipopolysaccharide(LPS) Outer membrane proteins (OMPs I,II,III)

  9. Male Urethritis Stricture Periurethral abscesses with sinuses (Watercan perineum) Prostate Seminal vesicles Epididymis Both sexes New born Proctitis Opthalmia neonatorum Conjunctivitis Arthritis Female Urethra Cervix uteri Endometrium Prepubertal Girls Fallopian tubes Vulvovaginitis Sterility

  10. Laboratory Diagnosis Specimens Urethral discharge, cervical swabs Gram negative cocci in pairs within pus cells Microscopy Gram stain Culture Chocolate agar: Translucent colonies Selective media Modified Thayer Martin (Vanco + Colistin + Nystatin) Identification tests Oxidase + Catalase + Glucosefermentation Maltose No fermentation Antibiotic susceptibility test Penicillin, Ceftriaxone, Tetracycline, Spectinomycin

  11. Treatment Single IM Ceftriaxone for uncomplicated IM Spectinomycin for patients allergic to cephalosporins 10-20% of males & 30-50% of females have coexisting Chlamydial infections Hence Doxycycline effective against chlamydia is often included as part of the treatment regimen for gonorrhea

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