Gram Stain: gram-negative
Morphology and structure: non-capsulated diplococci
Physiology: aerobic, metabolizes only glucose
Virulence factors: Type IV Pili (has antigenic variation), Porins, and Opa mediate attachment and penetration into cell - then multiplication of the organism occurs intracellularly (specifically within PMNs)
Major associated diseases:
· Gonorrhea
o Epidemiology: Gonorrhea is the second most common STI
o Symptoms: Thick white purulent discharge
§ Male: Urethritis (purulent urethral discharge) and dysuria
§ Female: vaginal discharge, dysuria and abdominal pain (asymptomatic carriage in female)
· Pelvic Inflammatory Disease (PID), Ectopic pregnancy, sterility and Fitz-Hugh-Curtis Syndrome (infection of the liver capsule)
§ Neonates: are at risk for developing Ophthalmia neonatorum (a purulent ocular infection acquired at birth) which is acquired during the passing of the birth canal of an infected mother
§ Asymmetric Arthritis - most common form of inflammatory arthritis in young adults.
Diagnosis: gram stain, culture, and PCR
Combined with testing for chlamydia - the test is sensitive, specific and rapid.
Treatment: Ceftriaxone via IM injection (and doxycycline for highly likely coinfection with Chlamydia)
Resistance is a growing concern. Resistance has developed to oral agents (e.g. quinolones, which are no longer used for this reason).