Infectious diseases. Gonococcal infection. Etiology. Epidemiology. Pathomorphology. Pathogenesis (most important)

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Infectious diseases. Gonococcal infection. Etiology. Epidemiology. Pathomorphology. Pathogenesis (most important)

Lecture notes, cheat sheets

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11. Gonococcal infection. Etiology. Epidemiology. Pathomorphology. Pathogenesis

Gonorrhea is an acute infectious sexually transmitted disease caused by Neisseria gonorrhoeae.

Etiology. The causative agent of gonorrhea - N. gonorrhoeae - refers to aerobic gram-negative diplococci. Serological studies revealed 16 gonococci. Gonococci infect organs covered with columnar epithelium. Stratified squamous epithelium is affected in children and older women.

Epidemiology. Newborns become infected with gonorrhea during childbirth and through contact with contaminated objects. Young children become ill as a result of domestic contact with parents or caregivers. Adolescents in most cases become infected through sexual contact.

Pathomorphology. Inflammatory changes first appear in the epithelium at the site of penetration of the gonococcus and are due to the released endotoxin, consisting of a whitish-yellow discharge, consisting of serum, leukocytes and desquamated epithelium, which often clogs the ducts of the paraureteral or vaginal glands, causing the formation of cysts or abscesses.

In untreated patients, the inflammatory exudate is replaced by fibroblasts, tissue fibrosis is accompanied by narrowing of the ureter of the urethra.

Gonococci that have penetrated into the lymphatic and blood vessels provoke the development of inguinal lymphadenitis, perineal, perianal, ischiorectal and periprostatic abscesses or dissemination of pathogens and damage to various organs.

Pathogenesis. Pathogens that have fallen on the mucous membranes of the genitourinary tract, conjunctiva, pharynx or rectum are attached to its cells by ciliated structures, which are protein outgrowths on the surface of the microorganism. They protect the pathogen from the action of antibodies and complement and may determine its antiphagocytic properties. Gonococci have a capsule. The multiplicity of types of pathogen, differing in the composition of the capsule, explains the frequency of relapses of the disease. The thickness of the walls of the vagina, the pH of its contents significantly affect the development of gonococci. A widespread infection most often develops after inoculation of the pathogen in the pharynx or rectum.

Gonococcal infection is accompanied by a pronounced immunological restructuring in the majority of patients who develop specific antibodies (normal and secretory IgA) in serum and lymphocytes are sensitized. Despite the presence of serum antigonococcal and secretory antibodies and sensitized lymphocytes, immunity to gonorrhea remains fragile, and reinfections are common.

Gonococci isolated from the disseminated form of the disease require special culture conditions and are more susceptible to low concentrations of antibiotics. In addition, the serum of patients with uncomplicated gonorrhea is more bactericidal than the serum of patients with disseminated forms of the disease.

Author: Pavlova N.V.

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