162.2 📚 國考版

162.2.0.1 必背 — 鑑別

• Gram - kidney bean diplococcus
• Glucose only (vs N. meningitidis glucose + maltose)
• 通常 intracellular in PMN (urethral discharge)

162.2.0.2 必背 — 臨床

• ♂ urethritis (#1 sx)
• ♀ cervicitis / PID 不孕 ectopic Fitz-Hugh-Curtis
• Pharyngitis (MSM)
• DGI: 三聯 (tenosynovitis + dermatitis + arthralgia) 或 purulent monoarthritis
• Ophthalmia neonatorum (2-5d), 失明 risk → topical erythromycin 預防

162.2.0.3 必背 — 治療 (2020 update)

• Ceftriaxone 500 mg IM × 1 (doubled)
• + Doxy 100 bid × 7d for chlamydia coverage
• DGI: ceftriaxone 1 g IV/IM q24h × 7d

162.2.0.4 必背 — 同時 screen

• HIV, syphilis, chlamydia, HBV
• Repeat screen 3 mo
• 通報

162.2.0.5 必背 — Complement deficiency + recurrent DGI

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