03 Gm Negative Cocci

Neisseria

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  • pink handcuff: Gram negative diplococci

  • blue ring: Oxidase positive

  • ferments glucose. Meningiditis also ferments maltose

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  • Vice City Private Investigator: Growth on VPN agar

  • Thayer Martin: Alternate name for VPN agar

  • Chocolate bar: Growth on chocolate agar

The commonly used antibiotics are vancomycin to inhibit gram-positive bacteria, colistin (i.e., polymyxin) to inhibit gram-negative bacteria (commensal Neisseria species but not N. meningitidis or N. gonorrhoeae), nystatin to inhibit yeast, and trimethoprim to inhibit the Proteus species.

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  • Mac: Patients with C5-C9 deficiency are unable to form MAC complex, leading to increased infections

  • 5-9PM: C5-C9 deficiency

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  • chains: Pili demonstrate antigenic variation. Fimbriae

  • card: IgA protease - cleaves IgA at hinge region

Neisseria Meningiditis

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  • Dorm room: Easily spread in close quarters like college dorms

  • Communist flag: Sickle cell and asplenic patients at higher risk of infection

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  • Malt liquor: Ferments maltose in addition to glucose. Compare with neisseria gonorrhea

  • plastic bags on floor: Polysaccharide capsule inhibits phagocytosis

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  • Q tip: Colonizes nasopharynx first. Transmitted by respiratory secretions.

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  • Syringe, A, C, D: Vaccine contains polysaccharide capsule

  • No syringe: Type B capsule not included in vaccine

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  • Envelope burning: LOS envelope proteins cause inflammatory response

  • Water leaking: Inflammation leads to leaky capillaries

  • Electric circuit: Capillary leakage can lead to hypovolemia and shock

  • Underwear with red dots: Characteristic petechial rash indicates thrombocytopenia

  • Wet floor spots: Petechial rash from thrombocytopenia. Risk of DIC

  • Petechial rash from thrombocytopenia. Risk of DIC

  • Water house: Waterhouse-Friderichsen syndrome, characterized by hemorrhage of adrenals (adrenal insufficiency, low bp, shock, DIC)

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  • Ceftriaxone treatment

  • Rifampin prophylaxis in close contacts

Neisseria Gonorrhea

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  • Red pillows in white chairs: Gram negative diplococci, facultative intracellular in PMNs

  • Broken glass: not encapsulated

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  • chandelier: Causes Pelvic Inflammatory Disease in females

  • white on table: Characteristic white purulent discharge

  • Band name: Fitz Hugh Curtis Syndrome: spread of PID into peritoneum

  • violin: Violin string adhesions form to capsule of liver

  • covering baby's eyes: Early onset conjunctivitis in newborns

  • cracked knee: Asymmetric arthritis, commonly in knee

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  • Ceftriaxone treatment

  • clam: Chlamydia coinfection, doxycyclinen and macrolide

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  • woman at bar: Sexually Transmitted Infection (the sexual tension is palpable)

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