Gonococcal scalp abscess in a neonate delivered by caesarean section

Atypical, Yet Not Infrequent, Infections with Neisseria Species

Neisseria species are extremely well-adapted to their mammalian hosts and they display unique phenotypes that account for their ability to thrive within niche-specific conditions. The closely related species N. gonorrhoeae and N. meningitidis are the only two species of the genus recognized as strict human pathogens, causing the sexually transmitted disease gonorrhea and meningitis and sepsis, respectively. Gonococci colonize the mucosal epithelium of the male urethra and female endo/ectocervix, whereas meningococci colonize the mucosal epithelium of the human nasopharynx. The pathophysiological host responses to gonococcal and meningococcal infection are distinct. However, medical evidence dating back to the early 1900s demonstrates that these two species can cross-colonize anatomical niches, with patients often presenting with clinically-indistinguishable infections. The remaining Neisseria species are not commonly associated with disease and are considered as commensals within the normal microbiota of the human and animal nasopharynx. Nonetheless, clinical case reports suggest that they can behave as opportunistic pathogens. In this review, we describe the diversity of the genus Neisseria in the clinical context and raise the attention of microbiologists and clinicians for more cautious approaches in the diagnosis and treatment of the many pathologies these species may cause.

Sexually Transmitted Infections in Pregnant Women: Integrating Screening and Treatment into Prenatal Care

Chlamydia, gonorrhea, and syphilis continue to be significant burdens to the health of pregnant women and their children despite easy and effective guidance for screening and treatment. Specific guidelines exist for screening for these infections as well as treatment and follow-up. In this article, we review the epidemiology of chlamydia, gonorrhea, and syphilis. Testing methodology is also reviewed as molecular-based techniques have replaced culture as the current gold standard tests of choice for chlamydia and gonorrhea. The nontreponemal and treponemal serologic diagnostic and screening approach to syphilis has undergone less change. Treatment for gonorrhea includes a one-time dose of parenteral ceftriaxone and oral azithromycin. This treatment regimen not only addresses the possible gonococcal resistance seen in recent years but also treats chlamydia, which may present similarly or co-infect the same patient. Syphilis treatment in both pregnant women and their infected neonates remains with penicillin G formulations. It is crucial to establish close follow-up evaluation for the pregnant woman infected with these sexually transmitted infections to ensure adequate treatment and help prevent perinatal spread of the infection.

Extragenital manifestations of Neisseria gonorrhoeae

Neisseria gonorrhoeae is a common cause of genitourinary sexually transmitted infections. N. gonorrhoeae is an obligate human pathogen that has evidence of tissue-specific host interactions and diverse extragenital manifestations of infection both in adult and pediatric populations. The clinical presentation of extragenital gonorrhea, diagnostic methods, treatment and preventive measures are reviewed.