N. gonorrhoeae characteristics

N gonorrhoeae characteristics

MICROBIAL ETIOLOGY

 

  1. N. gonorrhoeae

This bacteria causes many cases of PID in populations with high incidence rates of gonorrhea (i.e., inner city).

Acute PID is developed in 10% to 20% of women with endocervical gonorrhea.

  1. trachomatis

This organism is an important cause of PID.

It is the predominant etiologic agent among patients of middle and upper socioeconomic status with PID in the United States.

More than 50% of PID cases are caused by N. gonorrhoeae, C. trachomatis, or both.

Polymicrobial infection: Other microorganisms exist as causative agents for the disease, including facultative and anaerobic bacteria such as the following:

Escherichia coli

Gardnerella vaginalis

Bacteroides species

Haemophilus influenza

Mycoplasma hominis

Mycobacterium tuberculosis is an important cause of chronic PID in developing countries.

 

 

SIGNS AND SYMPTOMS

Lower abdominal pain: usually bilateral, most common presenting symptom

Abnormal vaginal discharge

Abnormal uterine bleeding

Dysuria: 20% of patients

Dyspareunia: common

Nausea and vomiting: may suggest peritonitis

Fever

Right upper quadrant tenderness (perihepatitis): 5% of PID cases

 

 

 

LABORATORY FINDINGS

Leukocytosis

Elevated acute phase reactants: erythrocyte sedimentation rate (ESR), C-reactive protein

Gram stain of endocervical exudate: greater than 30 PMNs per high-power field (HPF) correlates with chlamydial or gonococcal infection

Endocervical cultures for N. gonorrohoeae and C. trachomatis

Fallopian tube aspirate or peritoneal exudate culture if laparoscopy performed

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