Neisseria infections

Lindstrom Carlsson, 1993 Rotmensch et ah, 1994). Spheroid-like hollow bodies with a multicellular epithelial morphology have also been utihzed as a model of pathogenesis of infection as a result of Neisseria infection. Numerous cell-cell contacts representative of cells in vivo have been demonstrated in spheroids from nasopharyngeal cells, e.g. junctional complexes, desmosomes, specific orientation of the cytoskeleton and cellular organelles (Boxberger et aL, 1993). 

Archibald FS and Duong MN Superoxide Dismu-tase and Oxygen Toxicity Defenses in the Genus Neisseria. Infect. Immun. 1986 51 (2) 63141. 

Complement deficiencies are associated with several diseases. Alternative pathway deficiencies are rare, but when they exist more than one-half of factor D or properdin-deficient individuals suffer from Neisseria infections of which 75% are fatal. Individuals with deficiencies in the MAC components, e.g., C5, C6, Cl, and C8, are also susceptible to infection with Neisseria. Deficiencies in C1, C4, and C2 are associated with systemic lupus erythematosus and glomerulonephritis. Hereditary angioedema, a disease characterized by recurrent submucosal and subcutaneous edema, is caused by a deficiency in Cl inhibitor. Complexes and interactions similar to those of the complement system are also characteristic of the clotting system (Chapter 36). 

Lewis LA, Ram S, Prasad A et al. Defining targets for complement components C4b and C3b on the pathogenic neisseriae. Infect Immun 2008 76 339-350. 

Meropenem (Merrem IV) inhibits syndiesis of die bacterial cell wall and causes die deadi of susceptible cells. This drug is used for intra-abdominal infections caused by Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, and odier susceptible organisms Meropenem also is effective against bacterial meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae, and Hemophilus influenzae. 

Chloroquine (Aralen) is also used in die treatment of extraintestinal amebiasis (see section on Amebicides). Doxycycline is also used to treat infections caused by Neisseria gonorrhoeae, Treponema pallidum, Listeria monocytogenes, Clostridium, and Bacillus anthracis when penicillin is contraindicated. Quinine also may be used for die prevention and treatment of nocturnal leg cramps. 

Virus infections such as influenza and the common cold (in reality 300-400 different strains ofrhinovirus) infect epithelial cells ofthe respiratory tract and nasopharynx, respectively. Release ofthe virus, after lysis ofthe host cells, is to the void rather than to subepithelial tissues. The epithelia is further infected resulting in general degeneration ofthe tracts. Such damage predisposes the respiratory tract to infection with opportunistic pathogens such as Neisseria meningitidis and Haemophilus influenzae. 

The treatment of bacterial infections of the central nervous system highlights a number of important therapeutic considerations. Bacterial meningitis is caused by a variety of bacteria although their incidence varies with age. In the neonate, E. coli and group B streptococci account for the majority of infections, while in the preschool child H. influenzae is the commonest pathogen. Neisseria meningitidis has a... 

Hyperacute bacterial conjunctivitis is associated with gonococcal infections in sexually active patients. The causative agents are Neisseria gonorrhoeae or N. meningitidis. Prompt work-up and treatment is required, as corneal perforation occurs in 10% of cases within 48 hours.12 An ophthalmologist should complete a conjunctival scraping and susceptibility testing.10... 

Bacterial meningitis is the most common cause of CNS infections. An epidemiologic review of bacterial meningitis in 1995 revealed that Streptococcus pneumoniae (pneumococcus) was the most common pathogen (47%), followed by Neisseria... 

Gonorrhea is a curable STI caused by the gram-negative diplococcus Neisseria gonorrhoeae. Proper therapeutic management with antimicrobial agents is essential to eradicate this infection and prevent the development of associated sequelae. 

Newhall, J., Sawyer, W.D., and Haak, R.A. (1980) Cross-linking analysis of the outer membrane proteins of Neisseria gonorrhoeae. Infect. Immun. 28, 785-791. 

Girgis N, Sultan Y, Frenck RW Jr, El-Gendy A, Farid Z, Mateczun A Azithromycin compared with rifampin for eradication of nasopharyngeal colonization by Neisseria meningitidis. Pediatr Infect Dis J 1998 17 816— 819. 

Cuevas LE, Kazembe P, Mughogho GK, Til-lotson GS, Hart CA Eradication of nasopharyngeal carriage of Neisseria meningitidis in children and adults in rural Africa A comparison of ciprofloxacin and rifampicin. J Infect Dis 1995 171 728-731. 

CNS infections may be caused by a variety of bacteria, fungi, viruses, and parasites. The most common causes of bacterial meningitis include Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, and Haemophilus influenzae. 

Neisseria gonorrhoeae is a gram-negative diplococcus estimated to cause up to 600,000 infections per year in the United States. Humans are the only known host of this intracellular parasite. 

Zenni MK, Giardina PC, Harvey HA, et al. Macropinocytosis as a mechanism of entry into primary human urethral epithelial cells by Neisseria gonorrhoeae. Infect Immiin 2000 68(3) 1696-1699. 

Clotrimazole is an imidazole antifungal agent indicated for the treatment of fungal infections caused by Candida albicans. The administration of clotrimazole would be of no use in the treatment of infections caused by Chlamydia trachomatis, Neisseria gonorrhoea, Staphylcoccus aureus and Streptococcus pneumoniae. 

Serial estimates of immunofluorescent antibodies in sera obtained from 10 male volunteers who were infected with virulent strains of Neisseria... 

Sulfouamides have a broad spectrum of antimicrobial activity, including Staphylococcus aureus, nonenterococcal types of Streptococcus, Listeria monocytogenes, Nocardia, Neisseria, Haemophilius influenzae, enteric Gram-negative types of E. coli, Proteus mirabilis, and a few forms of anaerobic bacteria. Above all, sulfonamides are used for treating uncomplicated infections of the urinary tract, infections caused by Nocardia asteroids, streptococcal pharyngitis, menigococcal diseases, toxoplasmosis, and others. 

Alternative therapy for the following infections when penicillin is contraindicated Uncomplicated gonorrhea due to Neisseria gonorrhoeae] syphilis due to Treponema pallidum, yaws due to T. pertenue] Listeria monocytogenes] anthrax due to Bacillus anthracis] Vincent s infection due to Fusobacterium fusiforme] actinomycosis due to Actinomyces sp. Clostridium sp. 

Neisseria meningitidis carriers Treatment of asymptomatic carriers of N. meningitidis to eliminate meningococci from the nasopharynx. Not indicated for treatment of meningococcal infection. 

Acute salpingitis (pelvic inflammatory disease) due to Neisseria gonorrhoeae. Chlamydia trachomatis, or both is often complicated by superinfection with gramnegative bacilli and anaerobes. A combination of gentamicin, clindamycin, and doxycycline has been shown to be an effective treatment for this polymicrobial infection. 

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