Neisseria meningitidis y el aumento del sexo oral. A propósito de un caso

IF 0.8 4区医学 Q4 ANDROLOGY

Revista Internacional De Andrologia Pub Date : 2023-01-01 DOI:10.1016/j.androl.2021.02.010

Jaime Borràs , Carles Alonso-Tarrés , Alvaro Vives , Juan Palou

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引用次数: 1

Abstract

Urethritis is an entity characterized by dysuria and purulent urethral discharge, generally acquired sexually. Neisseria gonorrhoeae is one of the most frequently responsible microorganisms. Neisseria meningitidis is a gram-negative diplococcus usually isolated in the pharynx, that occasionally causes meningococcal meningitis, being unusual it's isolation in the anogenital area where it could be a genitourinary pathogen.

We present the case of a 25-years-old heterosexual male who, after a heterosexual intercourse with an occasional non-professional partner, including oral and vaginal sex, presented with symptoms of urethritis, orienting to a sexually transmitted infection. The bacteriological culture for N. gonorrhoeae was negative and the PCR for Chlamydia trachomatis was positive. Subsequently, the lab reported a positive bacteriological culture for sero-group C N. meningitidis, sensitive to ceftriaxone and a negative PCR for N. gonorrhoeae.

N. meningitidis is the main cause of bacterial meningitis, but genomic studies have suggested that alleles of nitrate reductase, factor-H biding protein and capsule are associated with N. meningitidis isolation in genitourinary infections. Transmission from the oropharynx to the urethra through orogenital contact in unprotected oral sex has been widely proven.

N. meningitidis prevalence as the cause of the urethritis is low, and the asymptomatic carriers in the urethra are extremely rare.

PCR is a method for the N. gonorrhoeae and C. trachomatis diagnoses, but it does not detect N. meningitidis. The gonorrhoea diagnosis is based on an increased number of polymorphonuclear cells, with intracellular gram-negative diplococci in Gram’ stain of urethral discharge. In our case, the gram-negative diplococcus seen in the stain was a meningococcus.

Urethritis due to N. meningitidis is indistinguishable from the secondary to N. gonorrhoeae, mimicking it even microscopically, only the epidemiology varies.

The conventional bacteriological culture continues to be essential for a correct diagnosis.

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脑膜炎奈瑟菌与口交增加。关于一个案件

尿道炎是一种以排尿困难和脓性尿道分泌物为特征的实体，通常是性获得的。淋病奈瑟菌是最常见的致病微生物之一。脑膜炎奈瑟菌是一种革兰氏阴性双球菌，通常在咽部分离，偶尔会引起脑膜炎球菌性脑膜炎，在肛门生殖器区域分离是不寻常的，它可能是泌尿生殖道病原体。我们报告了一例25岁的异性恋男性，他在与偶尔的非专业伴侣进行异性性交（包括口交和阴道性交）后，出现尿道炎症状，倾向于性传播感染。淋球菌的细菌培养呈阴性，沙眼衣原体的聚合酶链式反应呈阳性。随后，该实验室报告了对头孢曲松敏感的C群脑膜炎奈瑟球菌的细菌培养呈阳性，淋病奈瑟菌的PCR呈阴性。脑膜炎奈瑟菌是细菌性脑膜炎的主要原因，但基因组研究表明，硝酸还原酶、因子H结合蛋白和荚膜的等位基因与泌尿生殖系统感染中脑膜炎奈瑟杆菌的分离有关。在无保护的口交中，口咽通过身体接触传播到尿道已被广泛证明。作为尿道炎病因的脑膜炎流行率较低，尿道中无症状携带者极为罕见。聚合酶链式反应是诊断淋球菌和沙眼衣原体的一种方法，但它不能检测脑膜炎奈瑟菌。淋病的诊断是基于多形核细胞数量的增加，尿道分泌物的革兰氏染色中有细胞内革兰氏阴性双球菌。在我们的病例中，染色中看到的革兰氏阴性双球菌是脑膜炎球菌。脑膜炎奈瑟菌引起的尿道炎与淋病奈瑟菌继发性尿道炎难以区分，即使在显微镜下也很相似，只是流行病学不同。常规细菌培养对于正确诊断仍然至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Internacional De Andrologia ANDROLOGY-

CiteScore

1.60

自引率

12.50%

发文量

审稿时长

>12 weeks

期刊介绍： Revista Internacional de Andrología es la revista oficial de la Asociación Española de Andrología, Medicina Sexual y Reproductiva (ASESA), la Sociedade Portuguesa de Ardrologia, la Sociedad Argentina de Andrología (SAA), la Asociación Iberoamericana de Sociedades de Andrología (ANDRO), y la Federación Española de Sociedades de Sexología. La revista publicada trimestralmente es revisada por pares y es líder en el la especialidad y en español y portugués. Recientemente también publica artículos en inglés. El objetivo de la revista es principalmente la promoción del conocimiento y la educación médica continua, con un enfoque especial en el público español y latinoamericano, a través de la publicación de las contribuciones importantes de la investigación en el campo. Todos los miembros de las sociedades antes mencionadas reciben la revista y otros suscriptores individuales e institucionales de España, Portugal y América Latina.