Page 140 - Review of Medical Microbiology and Immunology ( PDFDrive )

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CHAPTER 16 Gram-Negative Cocci
129

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mebooksfree.com mebooksfree.com mebooksfree.com FIGURE 16–2 Gonorrhea. Note purulent urethral discharge mebooksfree.com
FIGURE 16–1
Meningococcemia. Note purpuric lesions on leg
caused by Neisseria gonorrhoeae. (Reproduced with permission from Wolff K,
caused by endotoxin-mediated disseminated intravascular coagula-
Johnson R (eds): Fitzpatrick’s Color Atlas & Synopsis of Clinical Dermatology. 6th ed.
tion (DIC). (Reproduced with permission from Wolff K, Johnson R (eds): Fitzpatrick’s
New York: McGraw-Hill, 2009. Copyright © 2009 by The McGraw-Hill Companies, Inc.)
Color Atlas & Synopsis of Clinical Dermatology. 6th ed. New York: McGraw-Hill, 2009.
Copyright © 2009 by The McGraw-Hill Companies, Inc.)

1
TABLE 16–1 Neisseriae of Medical Importance
Polysaccharide Maltose β-Lactamase Available Vaccine
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Capsule
Production
Species
Portal of Entry
Fermentation
+
Respiratory tract
+
+
N. meningitidis (meningococcus)
None
–
Some
N. gonorrhoeae (gonococcus)
–
Genital tract
1
All neisseriae are oxidase-positive.
TABLE 16–2 Important Clinical Features of Neisseriae
Organism
Typical Disease
Pyogenic
N. meningitidis
Meningitis, meningococcemia
Penicillin G

Pyogenic
N. gonorrhoeae Type of Pathogenesis Disseminated gonococcal infection Treatment 1 1 1,2 2

mebooksfree.com mebooksfree.com 4. Neonatal Conjunctivitis (ophthalmia neonatorum) Ceftriaxone 3 mebooksfree.com mebooksfree.com
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1. Local

Ceftriaxone plus doxycycline
Gonorrhea (e.g., urethritis, cervicitis)
Pelvic inflammatory disease
Cefoxitin plus doxycycline
2. Ascending

Ceftriaxone

3. Disseminated

1
Other drugs can also be used. See treatment guidelines published by the Centers for Disease Control and Prevention.
2
Add doxycycline for possible coinfection with Chlamydia trachomatis.
3
For prevention, use erythromycin ointment or silver nitrate drops.
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