ABSTRACT
Neisseria gonorrhoeae is a capnophilic gram-negative diplococcus that is the cause of the sexually transmitted disease (STD) gonorrhea. The gonococcus causes urethritis in men, cervicitis or urethritis in women, and, in women, it can extend into the peritoneal cavity where it causes pelvic inflammatory disease (PID). Rarely, the gonococcus enters the bloodstream where it causes disseminated gonococcal disease. Host tissue injury is mediated by the florid inflammatory response of infiltrating polymorphonuclear leukocytes. The gonococcus is adept at evading both innate and adaptive immunity. It can inhibit the complement cascade and avoid targeting by opsonizing antibodies by varying surface exposed molecules by phase and antigenic variation. As a result, a gonococcal vaccine is yet to be successfully developed. Diagnosis entails examination of gram-stained samples, bacterial culture or nucleic acid-amplification tests (NAATs). Prevention depends on safe sexual practices. The gonococcus is resistant to many antibiotics and therapy is restricted, currently, to ceftriaxone.
