TAILIEUCHUNG - Chapter 137. Gonococcal Infections (Part 1)

Harrison's Internal Medicine Chapter 137. Gonococcal Infections Definition Gonorrhea is a sexually transmitted infection (STI) of epithelium and commonly manifests as cervicitis, urethritis, proctitis, and conjunctivitis. If untreated, infections at these sites can lead to local complications such as endometritis, salpingitis, tuboovarian abscess, bartholinitis, peritonitis, and perihepatitis in female patients; periurethritis and epididymitis in male patients; and ophthalmia neonatorum in newborns. Disseminated gonococcemia is an uncommon event whose manifestations include skin lesions, tenosynovitis, arthritis, and (in rare cases) endocarditis or meningitis. Microbiology Neisseria gonorrhoeae is a gram-negative, nonmotile, non-spore-forming organism that grows singly and in pairs (., as monococci and diplococci,. | Chapter 137. Gonococcal Infections Part 1 Harrison s Internal Medicine Chapter 137. Gonococcal Infections Definition Gonorrhea is a sexually transmitted infection STI of epithelium and commonly manifests as cervicitis urethritis proctitis and conjunctivitis. If untreated infections at these sites can lead to local complications such as endometritis salpingitis tuboovarian abscess bartholinitis peritonitis and perihepatitis in female patients periurethritis and epididymitis in male patients and ophthalmia neonatorum in newborns. Disseminated gonococcemia is an uncommon event whose manifestations include skin lesions tenosynovitis arthritis and in rare cases endocarditis or meningitis. Microbiology Neisseria gonorrhoeae is a gram-negative nonmotile non-spore-forming organism that grows singly and in pairs . as monococci and diplococci respectively . Exclusively a human pathogen the gonococcus contains on average three genome copies per coccal unit this polyploidy permits a high level of antigenic variation and the survival of the organism in its host. Gonococci like all other Neisseria species are oxidase positive. They are distinguished from other neisseriae by their ability to grow on selective media and to utilize glucose but not maltose sucrose or lactose. Epidemiology The incidence of gonorrhea has declined significantly in the United States but there were still 325 000 newly reported cases in 2006. Gonorrhea remains a major public health problem worldwide is a significant cause of morbidity in developing countries and may play a role in enhancing transmission of HIV. Gonorrhea predominantly affects young nonwhite unmarried less educated members of urban populations. The number of reported cases probably represents half of the true number of cases a discrepancy resulting from underreporting self-treatment and nonspecific treatment without a laboratory-proven diagnosis. The number of reported cases of gonorrhea in the United States rose from 250 000 in the .

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