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
