CASE 4
A 19-year-old man complains of a purulent discharge (pus) from the penis and burning with urination for three days. He has no fever or other manifestations. He states that he has had numerous sex partners, does not consistency use condoms, and had sex with a new partner he met at a party four days before the onset of symptoms. His physical examination is normal except for spontaneous discharge of pus from the urethral meatus.
Questions
1. What are the usual sites of infection with Neisseria gonorrhoeae ?2. What other sites may be infected?
3. Describe the mechanisms of attachment of Neisseria gonorrhoeae to host cells.4. What elicits the intense inflammatory response (pus) in the urethra? Does the response occur in females?
5. What is the reservoir of gonococcal disease in the population?
6. How would you diagnose this infection? Is a gram stain of the pus sensitive or specific? How useful is the Gram stain in females?
7. How would you treat this patient?
8. What is the most likely cause of treatment failure?
9. Why can't we develop a vaccine?