Gonorrhea: Pathophysiology



 - Neonatal Transmission -> Direct contact of patient mucosa with mother's infected mucosa while traveling down the birth canal 

 - Sexual Transmission -> Direct contact of patient mucosa with infected mucosa 

 - Autoinoculation -> Immediate transfer of bacteria to patient mucosa via indirect contact with infected mucosa



Bacterial components including: pili and other

proteins allow adherence to host mucosal cells

Attachment to the mucosal cell surface -> Bacteria invade and replicate within columnar epithelial cells -> Host Immune Response -> Successful eradication of pathogen. Pathogen cleared from host



Multi-factorial process leads to ability to avoid host immunity:

 - Antigenic variation of proteins and LPS on bacteria

 - Masking of gonococcal antigen by LPS prevents binding of bactericidal antibodies and causes incomplete activation of complement system

 - Molecular Mimicry (e.g. terminal LPS sugars similar to host glycolipids)

 - Secretion of IgA proteases

 - Blocking antigen by binding host antibodies to a bacterial reduction modifiable protein (Rmp)



#Gonorrhea #Pathophysiology #STDs #PrimaryCare #STIs