Gonorrhea

00:01 Our next organism here is Neisseria gonorrhoeae.

00:04 Look, this is a gram-negative organism.

00:06 It’s a diplococci.

00:08 It begins in the vestibular, that is your outside portion of the female genital tract.

00:16 And then also periurethral glands.

00:19 And your periurethral glands tend to be more of your Skene glands.

00:24 So if you’re unfamiliar with the glands in the vestibular area and the periurethral, probably a good time for you to quickly review it because these things will show up on your Step.

00:32 And you need to make sure that you know as to what they look like and how they present.

00:36 Both these patients -– the glands here in the vestibular area, my goodness, she’s going to be absolutely uncomfortable.

00:45 Lower tract symptoms, acute suppurative reaction.

00:49 Ascends up the mucosa surface to the tract and once again here, we have another bacteria that then may present with pelvic inflammatory disease.

01:00 Unfortunately, this infection is transmitted sexually and could also be transmitted to a newborn during vaginal delivery.

01:07 And at some point in microbiology, you’ve heard of ophthalmia neonatorum, right? Or conjunctivitis of the newborn.

01:15 And it might be either Neisseria or Chlamydia.

01:18 Or ophthalmoplegia neonatorum.

01:18 Oftentimes, you’ll find your Chlamydia responsible for it.

01:22 The extragenital infections that you want to keep in mind for Neisseria are the following: If there’s felacio or oral sex involved, cunnilingus and such, pharyngitis.

01:33 If there’s anal sex, then you’re thinking about infection in the rectum, proctitis.

01:40 Sometimes the infection moves away from the genital tract and if you take your hand -- The patient comes to you and says, “Doc, you see my knee? I’m having a hard time in moving around.

01:53 Definitely having a hard time jogging.

01:54 Sometimes I even have a hard time walking.” One or two? Both knees? How many? One.

02:01 One.

02:01 Oh, okay, monoarticular.

02:04 Take the back of your hand and you place the back of your hand on the knee and, whew, it feels a little warm to the touch.

02:11 This is septic arthritis, isn’t it? Or purulent arthritis.

02:15 Keep that in mind, please. Very important.

02:18 Be able to identify that issue.

02:21 And here’s the eye issue in a neonate with vertical transmission, and this is so unfortunate.

02:29 Here’s a sexually transmitted infection that should have treated.

02:32 Instead, the pregnant lady’s delivering and affecting the neonate.

02:37 That always makes me feel – I mean it just doesn’t make me feel good at all.

02:40 This is ophthalmia neonatorum, a neonatal conjunctival infection and it is severe.