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Chapter 9 : Complications and Long-Term Sequelae of Infections by

Author: Per-Anders Mårdh1
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Affiliations: 1: Department of Obstetrics and Gynaecology, Lund University, Lund, Sweden
Content Type: Monograph
Publication Year: 2009

Category: Clinical Microbiology

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Abstract:

The species in the genus belongs to the family , which consists mostly of gram-negative cocci that divide in two planes at right angles to each other. Gonococci can be detected in Gram-and methylene blue-stained smears of body secretions, in which characteristic “coffee bean” diplococci can be seen. Gonococci may also be detected in the rectum in patients with gonococcal proctitis; in eye secretions in cases of gonococcal conjunctivitis, including in newborns with ophthalmia neonatorum; in the oropharynx of patients with gonococcal pharyngitis; and in skin blisters in cases of disseminated gonococcal infections (DGI) (i.e., gonococcal septicemia). The chapter first focuses on epidemiology of gonorrhea. Next, it concentrates on long-term sequelae of gonorrhea, and specified complications. Gonococcal endometritis is usually regarded as part of an ascending infection reaching the fallopian tubes leading to salpingitis. Since it is difficult to distinguish between these entities clinically, the term pelvic inflammatory disease (PID) is used to cover both conditions. Serological studies have demonstrated that gonococci, chlamydia, and mycoplasma organisms are independently associated with tubal factor infertility (TFI). Both gonococci and chlamydia organisms can cause a profound destruction of the tubal epithelium. Ectopic or extrauterine pregnancy may be long-term sequela of gonococcal salpingitis. Urethral stricture is also one of the long-term sequelae of gonorrhea. Finally, the chapter focuses on primary and secondary interventions to reduce complications and sequelae of gonorrhea.

Citation: Mårdh P. 2009. Complications and Long-Term Sequelae of Infections by , p 169-185. In Fratamico P, Smith J, Brogden K (ed), Sequelae and Long-Term Consequences of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555815486.ch9

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Pelvic Inflammatory Disease
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Human immunodeficiency virus 1
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Complications and Long-Term Sequelae of Infections by Neisseria gonorrhoeae
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Citation: Mårdh P. 2009. Complications and Long-Term Sequelae of Infections by , p 169-185. In Fratamico P, Smith J, Brogden K (ed), Sequelae and Long-Term Consequences of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555815486.ch9
/content/10.1128/9781555815486.ch09.ch09fig01
Figure 1.
Microimmunofluorescent (MIF) and indirect hemagglutination (IHA) antibodies to in males and females attending a venereal disease clinic in Greenland.
10.1128/9781555815486/ch9fig1_thmb.gif
10.1128/9781555815486/ch9fig1.gif
Image of Figure 1.
Figure 1.

Microimmunofluorescent (MIF) and indirect hemagglutination (IHA) antibodies to in males and females attending a venereal disease clinic in Greenland.

Citation: Mårdh P. 2009. Complications and Long-Term Sequelae of Infections by , p 169-185. In Fratamico P, Smith J, Brogden K (ed), Sequelae and Long-Term Consequences of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555815486.ch9
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Figure 2.
Influence of cell-free culture filtrates of (A) and purified gonococcal endotoxin (B) on mucociliary wave activity in tissue cell culture of human fallopian tube epithelium.
10.1128/9781555815486/ch9fig2_thmb.gif
10.1128/9781555815486/ch9fig2.gif
Image of Figure 2.
Figure 2.

Influence of cell-free culture filtrates of (A) and purified gonococcal endotoxin (B) on mucociliary wave activity in tissue cell culture of human fallopian tube epithelium.

Citation: Mårdh P. 2009. Complications and Long-Term Sequelae of Infections by , p 169-185. In Fratamico P, Smith J, Brogden K (ed), Sequelae and Long-Term Consequences of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555815486.ch9
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Figure 3.
Electron micrograph showing gonococci and gonococcal endotoxin blebs, which can be seen as indistinct structures outside the epithelial cells. The endotoxin, in turn, influences the host cells to produce pseudopodia. There is a repelling force between gonococci and host cells, which are both negatively charged. The tip of a cell pseudopodium and the tip of a gonococcal pilus represent a minimal contact surface with a minimum of physical repelling force, which will facilitate the initial phase of an intracellular uptake of gonococci.
10.1128/9781555815486/ch9fig3_thmb.gif
10.1128/9781555815486/ch9fig3.gif
Image of Figure 3.
Figure 3.

Electron micrograph showing gonococci and gonococcal endotoxin blebs, which can be seen as indistinct structures outside the epithelial cells. The endotoxin, in turn, influences the host cells to produce pseudopodia. There is a repelling force between gonococci and host cells, which are both negatively charged. The tip of a cell pseudopodium and the tip of a gonococcal pilus represent a minimal contact surface with a minimum of physical repelling force, which will facilitate the initial phase of an intracellular uptake of gonococci.

Citation: Mårdh P. 2009. Complications and Long-Term Sequelae of Infections by , p 169-185. In Fratamico P, Smith J, Brogden K (ed), Sequelae and Long-Term Consequences of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555815486.ch9
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