Genitourinary
Image Set 20 - (Sparrow 5IIB1) Neisseria gonorrhoeae infection - urethral drainage
Image Set 20 - (Sparrow 5IIB1) Neisseria gonorrhoeae infection - urethral drainage
Results: Greater than 100 WBC's/hpf || Numerous gram negative diplococci || Intracellular and extracellular
Note: The majority of these bacteria demonstrate the typical rounded diplococci with flat adjacent sides (e.g. "coffee-bean" shape). This morphology is consistent with Neisseria and being found intracellular is suggestive of N. gonorrhoeae.
KEY POINTS: Gram negative diplococci that have a classic "kidney bean" shape. They are non-motile, non-spore forming and grow in culture only on chocolate agar. N. gonorrhea is a common sexually transmitted disease with an incidence in the USA of 200/100,000. This pathogen avoids immune system detection by antigenic variation of key protein structures during its infectious cycle. Because of markedly increasing resistance in N. gonorrheae, as of 2013 CDC recommends treatment of gonococcal infection with a single intramuscular dose of ceftriaxone. Concurrent treatment for Chlamydial infection (azithromycin or doxycline) is the standard, as dual infections are often present.
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