- neisseria = Gram-negative aerobic diplococcus
- An encapsulated organism, resistant to opsonization
- its capsule protects it against complement-mediated bacteriolysis and phagocytosis by neutrophils, Kupffer cells, and spleen macrophages.
- Rarely resistant (just watch us)
- Incubation 3-5 days
- Antibody-mediated immunity is the most potent defence
- The peak incidence of the disease occurs in the first year of life
(following the loss of maternal antibody)
- Progressively less common throughout childhood
- Extremely rare in immunocompetent adults
- LPS endotoxin as part of outer membrane
- polysaccharide capsule - evade host phagocytosis
- fimbriae mediate attachment to nasal epithelial cells
- produces IgA protease cleaving IgA antibodies
clinical presentation/complications
- ceftriaxone or benpen
- steroids not indicated unless meningitis present
- close contacts - rifampicin or ciprofloxacin
- highest risk: household contacts, highest in the 1st 7 days
- chemoprophylaxis aims to eliminate established carriage