Gonorrhoea
Neisseria gonorrhoeae is a gram-negative diplococcus that directly invades columnar and transitional epithelium, producing a florid local inflammatory response set against a backdrop of rapidly evolving antimicrobial resistance that dictates how it must be tested and treated.
First principles
An extracellular pyogenic organism produces a florid local response, unlike chlamydia
Neisseria gonorrhoeae attaches to and invades columnar and transitional epithelial cells (urethra, endocervix, rectum, pharynx, conjunctiva) via pili and outer membrane proteins, provoking an acute, neutrophil-rich inflammatory response with a short incubation period of only a few days. This brisk pyogenic reaction is why gonococcal urethritis in men classically produces a profuse purulent discharge and marked dysuria, in sharp contrast to the low-grade, often silent chlamydial infection of the same sites. The same biology means microscopy can show gram-negative intracellular diplococci within neutrophils, a direct visual signature of the organism's invasive behaviour.
Educational content pending clinical review. Not medical advice.