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Gram Negative Cocci Neisseriae ([2] Neisseria gonorrhea (Laboratory…

- - - - Headache
      - Altered mental status
    - - Phonophobia
    - - Photophobia
    - - Stiffness
    - - High fever
    - - If meningococcal infection => Petechiae (rash; bleeding under skin)
        Also vomiting & convulsions
  - - - Gram-stained smears of sediment of centrifuged CSF or of petechial aspirate often show extracellular & intracellular gram -ve diplococci
    - - Antibodies to meningococcal polysaccharides can be measured by latex agglutination or hemagglutination tests
      - These tests are only done in reference laboratories
- - - - In male: a yellow, purulent urethral discharge & painful urination
      - In females:
        
        A greenish yellow cervical discharge is most common
        
        Infertility occurs in approximately 20% of women
        
        Infection occurs in endocervix & extends to urethra & vagina
    - - Infection of the conjunctival sac that is acquired by a newborn during passage through birth canal of a mother infected w/ gonococcus
      - If untreated => blindness
      - Treatment is w/ Erythromycin b/c antibiotic also eradicates Chlamydia trachomatis, if present
  - - - Colony morphology on modified Thayer-Martin (MTM) agar : Small, raised gray, translucent
    - - Oxidase test: +ve
      - Carbohydrate utilization test: acid produced only in the glucose tube indicates that the isolate is N. gonorrheoae
      - Gram-stained smear
    - - Gram -ve diplococci in PMNs (pus cells) gives presumptive diagnosis
      - Stained smears of conjunctival exudates can also be diagnostic