1/8. Disseminated gonococcal infection in pregnancy presenting as meningitis and dermatitis.BACKGROUND: In 2003, the reported gonorrhea rate among women was 118.8 per 100,000 women. Most gonococcal infections in pregnant women are asymptomatic or produce a mildly symptomatic genital infection. Disseminated infections can occur when gonococcal bacteremia produces extragenital symptoms, most commonly arthritis. CASE: A patient presented in the third trimester of pregnancy with fever, body aches, neck soreness, and skin lesions. There was no arthritis. Cultures performed during evaluation confirmed extragenital neisseria gonorrhoeae. CONCLUSION: A high index of suspicion is necessary to diagnose disseminated gonococcal infection and prevent disease sequelae.- - - - - - - - - - ranking = 1keywords = gonorrhoeae (Clic here for more details about this article) |
2/8. Disseminated neisserial infection in pregnancy: the empress may have a change of clothing.A case of disseminated neisserial disease during pregnancy with good perinatal outcome is presented along with two examples of disseminated N. meningitidis from endocervical site. Upon close review, it is clear that the biological similarities of both N. gonorrhoeae and N. meningitidis may outweigh their differences. The two organisms may behave in clinically indistinguishable fashion and probably justify a more cautious approach to the clinical syndromes we have considered the inviolate domain of the gonococcus. The management of disseminated neisserial disease in pregnancy should include prompt empiric parenteral therapy while aggressive diagnostic confirmation of the organism is pursued. In addition, neonatal conjunctivitis caused by a Gram-negative diplococci should be treated parenterally until clinical response and identity of the organism is confirmed.- - - - - - - - - - ranking = 1.6032152734689keywords = gonorrhoeae, neisseria (Clic here for more details about this article) |
3/8. Successful therapy of penicillinase-producing neisseria gonorrhoeae pharyngeal infection during pregnancy.The relative frequency of pharyngeal gonococcal infection may be increased in certain prenatal populations. Therapy of penicillin-sensitive strains of neisseria gonorrhoeae is associated with acceptable cure rates using aqueous procaine penicillin with probenecid. infection of the oropharynx of pregnant women with penicillinase-producing strains is more problematic. The antibiotics normally used for the therapy of uncomplicated penicillinase-producing N gonorrhoeae infections, spectinomycin or cefoxitin, are not effective in the therapy of pharyngeal infection. Reported is the first case of penicillinase-producing N gonorrhoeae oropharyngeal infection during pregnancy. The patient was successfully treated with trimethoprim/sulfamethoxazole, and no maternal or neonatal morbidity was noted.- - - - - - - - - - ranking = 7keywords = gonorrhoeae (Clic here for more details about this article) |
4/8. Ruptured tubo-ovarian abscess in pregnancy: recovery of a penicillinase-producing strain of neisseria gonorrhoeae.This report describes a patient, 15 weeks pregnant, who developed progressive disease of the female genital tract due to a penicillinase-producing strain of neisseria gonorrhoeae. Standard therapy for gonorrhea did not abort progression of disease, which culminated in a ruptured tubo-ovarian complex in the second trimester of pregnancy.- - - - - - - - - - ranking = 5keywords = gonorrhoeae (Clic here for more details about this article) |
5/8. Gonococcal ophthalmia neonatorum after delivery by cesarean section: report of a case.This report describes a neonate delivered by cesarean section who had conjunctivitis due to neisseria gonorrhoeae. Evidence supporting the hypothesis that gonococcal conjunctivitis can be acquired in utero is provided by this case study, which also emphasizes that saline lavage is inappropriate after instillation of AgNO3 into the neonate's eyes.- - - - - - - - - - ranking = 1keywords = gonorrhoeae (Clic here for more details about this article) |
6/8. New issues in the prevention and treatment of ophthalmia neonatorum.We have recently seen two cases of ophthalmia neonatorum (ON) that illustrate a changing picture of this disease and raise a number of questions concerning optimal prophylaxis and treatment. silver nitrate, which is the most widely used method for prevention of gonococcal ON, fails to prevent neonatal eye disease due to chlamydia. In addition, strains of gonococci which produce a penicillinase and are resistant to penicillin are becoming common in parts of the united states and europe. Thus all gonococcal isolates must be tested for penicillinase production. The emergence of chlamydia trachomatis as the most frequent cause of ON and the appearance of penicillin-resistant gonococci has led to new regimens for prophylaxis and therapy of neonatal ophthalmia. At our institution, we now use intramuscular penicillin and topical tetracycline ointment (1%) for eye prophylaxis. For initial therapy of gonococcal ON we recommend penicillin (systemic and topical) plus another antimicrobial with greater stability against the penicillinase of neisseria gonorrhoeae.- - - - - - - - - - ranking = 1keywords = gonorrhoeae (Clic here for more details about this article) |
7/8. Preterm labour in association with neisseria gonorrhoeae: case reports.We describe two cases of spontaneous rupture of the membranes, followed by premature labour at 32 and 34 weeks' gestation, in association with gonococcal infection.- - - - - - - - - - ranking = 4keywords = gonorrhoeae (Clic here for more details about this article) |
8/8. Acute suppurative salpingitis with concomitant intrauterine pregnancy.A 20-year-old woman presented to the emergency department with a history of lower abdominal pain and recent loss of consciousness. She was admitted with a primary diagnosis of abdominal pain; ectopic pregnancy was ruled out. The culture of the endocervix was positive for neisseria gonorrhoeae. Surgical exploration of the pelvis was performed, and histological analysis of the specimen showed an acute suppurative salpingitis and an intrauterine pregnancy. The patient was placed on intravenous antibiotics. Postoperative course was unremarkable, and the patient was discharged on oral antibiotics. Although a rare entity acute suppurative salpingitis with concomitant intrauterine pregnancy are not mutually exclusive. Ectopic pregnancy should be the presumptive diagnosis when clinical presentation is consistent with pelvic inflammatory disease and pregnancy especially in the first trimester. patients who are pregnant and exhibit clinical signs and symptoms that are consistent with salpingitis should be admitted for aggressive management of their high-risk pregnancy. Fetal wastage seems to be significant in spite of aggressive management. Endocervical culture for N gonorrhoeae should be obtained from all pregnant patients with follow-up treatment pending culture results. The following is a case presentation along with a review of the existing cases in the English literature and discussion of the possible pathogenesis and clinical outcome of this entity.- - - - - - - - - - ranking = 2keywords = gonorrhoeae (Clic here for more details about this article) |