Neisseria spp.

Facultative Anaerobe

Neisseria
Pathogenic

Gram-Negative

Coccus
Coccus
Coccus

Diplococcus
Coccus
Neisseriaceae
Diplococcus
Acinetobacter

Neisseria

Neisseria meningitidis Flagella Neisseria gonorrhoeae

Catalase positive
Meningococcus Gonococcus
Oxidase positive

Meningitis Meningococcemia Gonorrhoeae

Virulence Factors Polysaccharide
Capsule

Antiphagocytic

13 Serogroups
A, B, C, D, E, H, I, K, L, X, Y, Z,
and W-135
Virulence Factors Polysaccharide Endotoxin or Lipopolysaccharide (LPS)
Capsule

Release Blebs of Endotoxins

Antiphagocytic
or LPS
• Petechiae
Major Causing:
13 Serogroups
Blood Vessel Destruction
A, B, C, D, E, H, I, K, L, X, Y, Z, Hemorrhage
and W-135 Sepsis

IgAI Protease Pili Extract Iron

Cleaves IgA in Half Attachment to Human

from Human
Nasopharyngeal Cells
Helps in Evasion of Transferrin
Humoral Immune Response Undergo Antigenic Variation
 Normal Flora
Meningococcal Disease
Attaches to
Epithelial Cells

Meningitis Meningococcemia

Anti-
Meningococcal
Antibodies

Naturally
Neisseria
Immunized
meningitidis
 Meningococcal Disease

Meningitis Meningococcemia

Fulminant
Meningococcaemia
Arthritis

Bulging
Fontanelle COMPLICATION
Disseminated
Intravascular
Coagulation (DIC)
Brudzinski’s Waterhouse-
Kernig Sign Friderichsen Syndrome
Sign
 Gram Stain Neisseria

Culture of the Meningococcus

Neisseria Neisseria
meningitidis gonorrhoeae
Ferments

Maltose
Glucose

Chocolate Agar Antibiotics

Neisseria

Thayer-Martin VCN
Vancomycin Gram +ve
Colistin (Polymyxin) Gram -ve
Nystatin Fungi
 Gram Stain Neisseria

Culture of the Meningococcus

Neisseria Neisseria
meningitidis gonorrhoeae
Ferments

Maltose Maltose
Glucose Glucose

Chocolate Agar Antibiotics

Neisseria

Thayer-Martin VCN
Vancomycin Gram +ve
Colistin (Polymyxin) Gram -ve
Nystatin Fungi
 Gram Stain Neisseria

Culture of the Meningococcus

Neisseria Neisseria
meningitidis gonorrhoeae
Ferments

Maltose Maltose
Glucose Glucose

Antibiotics Rapid Antigen Detection

Chocolate Agar
Nucleic Acid Amplification Tests
(NAAT )
Neisseria
Microscopy

Thayer-Martin VCN
Confirmation of Identification
Vancomycin Gram +ve
Colistin (Polymyxin) Gram -ve
Nystatin Fungi
 TREATMENT
Penicillin
Cefotaxime Chemoprophylaxis
1st Line Agents
4-5 Days
Allergic

Chloramphenicol Rifampicin
Ceftriaxone
Ciprofloxacin
PREVENTION
Outbreak
Meningococcal Group C Vaccine

Tetravalent (A, C, Y, W135) Epidemic

Polysaccharides Vaccine
Neisseria Gonorrhea
Neisseria spp.
 Glucose
Maltose
Ferments

Neisseria gonorrhea
Gonococcus

Disseminated Gonococcal Ophthalmia

Gonorrhea Infection (DGI) Neonatorum
 IN WOMEN
Pelvic Inflammatory
Disease

Cervical Motion Adnexal

Intermenstrual Tenderness Tenderness
Bleeding

Vaginal Discharge
from Endocervicitis

Dyspareunia
Vaginal Discharge
Lower Abdominal
Pain
Dysuria Dysuria
Lower Abdominal Mucopurulent Urethral
Pain Discharge

Intermenstrual
Bleeding
 IN MALES

Urethritis

Urethral Strictures

Acute
Epididymitis

Prostatitis Cystitis

Rectal Infection
Pain
Pruritus
Discharge
Tenesmus
 Disseminated Gonococcal Ophthalmia Neonatorum
Infection
Arthritis-Dermatitis
Syndrome

Early Stage Second Stage Bilateral Conjunctivitis

Joint or
Eye Pain
Septic
Tendon Pain Arthritis
Redness
Purulent Discharge
 Opa Proteins Gonococcus Pili

Promote Adherence & Protect from Antibodies

Invasion into Epithelial Cells
Adhere to Host Cells
Opaque Colonies
Prevent Phagocytosis

Porins, (PorA, PorB)

IgAI Protease
Protein I

Helps in Evasion of
Humoral Immune Promotes the Invasion
Response Endotoxin or LPS into Epithelial Cells

Destroys Cilia on
Neighbouring Cells
 Culture Microscopy

Nucleic Acid Amplification Tests

Urethra Cervix Rectum Conjunctiva Throat Synovial (NAAT )
Fluid

Chocolate Agar Antibiotics

Confirmation of Identification
Thayer-Martin VCN
Vancomycin Gram +ve
Colistin (Polymyxin) Gram -ve
Nystatin Fungi
 TREATMENT
Ceftriaxone
Ceftriaxone
Azithromycin / Doxycycline
Doxycycline

Urogenital Cefoxitin Epididymitis

Anorectal Ceftriaxone
Pharyngeal Doxycycline
Metronidazole
Cefotetan
Clindamycin Ceftriaxone
Gentamicin Cefotaxime
Ceftriaxone
Ceftizoxime
 PREVENTION

Avoiding Sexual Contact

with High-Risk Individuals
Treat Contacts of
Infected Individuals

Barrier in the
Development of Vaccine

Using Effective Barrier

Contraception Antigenic Variation in
Pili
 So, a 19-year-old college student presents to the ER
with headache, malaise, and fever 102°F). On
examination, there is nuchal rigidity and on the lower
extremities there are petechiae and purpura. What is
the most likely diagnosis?
Meningitis with Petechiae is most often associated with
Meningococcal Meningitis.
Which growth media is used for the isolation
and identification of N. gonorrhoeae?

Thayer-Martin Vancomycin, Colistin, and

Nystatin (VCN) Media
Next, A 23-year-old college student presents to a
hospital, complaining of painful urination and
purulent urethral discharge for the last 3 days.
Analysis of the discharge reveals gram-negative
diplococci. What is the offending pathogen?
Neisseria gonorrhoeae
 What virulence factor causes the petechiae
seen in meningococcal infections?

Endotoxin-mediated Blood vessel Destruction leading

to Blood Vessel Hemorrhage
Is vaginal and Penile Discharge caused by N.
Gonorrhoeae usually Purulent or Clear and
Why?

Purulent due to a Neutrophilic Exudate

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