Disseminated Gonococcal Infection in Pregnancy Presenting as Meningitis and Dermatitis

“…Asymptomatic infections or variation of host susceptibility associated with pregnancy was explained in part by immunological depression theory [3] , which was caused by the increase of serum progesterone. To confirm this hypothesis, the levels of progesterone and NO in serum were detected by radioimmunoassay and Griess reagent assay.…”

Section: Discussionmentioning

confidence: 99%

The nongenomic effects of progesterone in repressing iNOS activation through P38MAPK pathways in gonococci-infected polymorphonuclear leukocytes and the clinical significance

Chen

Lin

et al. 2010

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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Progesterone has nongenomic effects on inducible nitric oxide synthase (iNOS), which is mediated by mitogen activated protein kinase (MAPK) pathways. This effect is supposed to have some potential association with asymptomatic gonococcal infections in women by immunological depression. In this study, polymorphonuclear leukocytes (PMNs) challenged by gonococci were used to study the nongenomic effects of progesterone. The activation of iNOS was assessed by measuring [(3)H] L-arginine converses to [(3)H] L-citrulline, and the activity of MAPK was detected by Western blot. It was found that the activity of iNOS and the yields of NO were enhanced significantly in gonococci-challenged PMNs compared with the controls (P<0.01). Progesterone could repress the activation of iNOS through P38MAPK pathway within PMNs (P<0.05), which could be blocked by SB203580 (P<0.01), but not by actinomycin D (P>0.05). It was also found subsequently that in the serum specimens collected from gonococci-infected but asymptomatic women, the progesterone level was higher than that in women with severe symptoms (P<0.01). Moreover, the yield of NO had an inverse correlation with progesterone. With these results it suggested that the rapid nongenomic effects of progesterone may inhibit iNOS activation and NO yields mediated by P38MAPK pathways, which were supposed to be concerned with asymptomatic women infected with gonococci.

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“…The most common causative microorganisms were S. pneumoniae (25 cases; 60%) and L. monocytogenes (seven cases; 17%) [7][8][9][10][11][12][13][14][15][16][17][18][19]. Pathogens in other cases were Neisseria meningitidis (two), Haemophilus influenzae (one), Group A streptococci (two), Group B streptococci (two), Neisseria gonorrhoea (two) and Pasteurella multocida (one) [20][21][22][23][24][25][26][27][28][29].…”

Section: Review Of the Literaturementioning

confidence: 99%

“…Neisseria meningitidis [20,21] Haemophilus influenzae [22] Group A streptococci [23,24] Group B streptococci [25,26] Listeria monocytogenes [18,19] Neisseria gonorrhoea [27,28] Pasteurella multocida [29] Total No. of cases…”

Section: Causative Organismmentioning

confidence: 99%

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Bacterial meningitis in pregnancy: report of six cases and review of the literature

Adriani

Brouwer

Ende

et al. 2012

Clinical Microbiology and Infection

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Few cases of bacterial meningitis during pregnancy have been reported in the literature, and the causative microorganisms and prognosis of bacterial meningitis during pregnancy are unclear. In a 6-year period we identified six cases of bacterial meningitis in pregnant women. All were multigravida and gestational age at presentation ranged from 5 to 39 weeks. Predisposing factors were present in five patients and consisted of otitis in four patients. The causative organism was Streptococcus pneumoniae in all patients. Two patients died, both due to florid septic shock and brain herniation. Foetal outcome was good in five cases; one woman had a miscarriage 3 weeks after the episode of bacterial meningitis. We reviewed the literature on bacterial meningitis during pregnancy and identified 42 cases of bacterial meningitis. Twenty-five of these patients had pneumococcal meningitis and seven had meningitis caused by L. monocytogenes. We found that pneumococcal meningitis during pregnancy can be rapidly fatal and is associated with foetal death, especially in the first trimester. L. monocytogenes meningitis was associated with a high rate of neonatal deaths.

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Disseminated Gonococcal Infection in Pregnancy Presenting as Meningitis and Dermatitis

Abstract: A high index of suspicion is necessary to diagnose disseminated gonococcal infection and prevent disease sequelae.

Cited by 15 publications

References 4 publications

Antimicrobial Susceptibility of Neisseria gonorrhoeae Isolates in Yaoundé, Cameroon From 2009 to 2014

Antimicrobial Susceptibility of Neisseria gonorrhoeae Isolates in Yaoundé, Cameroon From 2009 to 2014

The nongenomic effects of progesterone in repressing iNOS activation through P38MAPK pathways in gonococci-infected polymorphonuclear leukocytes and the clinical significance

Bacterial meningitis in pregnancy: report of six cases and review of the literature

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