A 32-year-old man comes to the physician because of severe burning with urination for the past 3 days. During this period, he has had clear urethral discharge early in the morning. He has no history of serious illness, except for similar symptoms 3 months ago, and urethral swab microscopy showed numerous neutrophils and intracellular gram-negative diplococci. The symptoms resolved after treatment with ceftriaxone and doxycycline but recurred 4 days ago. The patient takes no medications. He is sexually active with one male and one female partner; they use condoms inconsistently. Temperature is 36.8°C (98.0°F), pulse is 75/min, and blood pressure is 135/78 mm Hg. Nucleic acid amplification testing of a clean catch urine specimen is positive for Neisseria gonorrhoeae and negative for Chlamydia trachomatis. Which of the following is the most likely reason for the recurrence of infection in this patient?

Question

A 32-year-old man comes to the physician because of severe burning with urination for the past 3 days. During this period, he has had clear urethral discharge early in the morning. He has no history of serious illness, except for similar symptoms 3 months ago, and urethral swab microscopy showed numerous neutrophils and intracellular gram-negative diplococci.  The symptoms resolved after treatment with ceftriaxone and doxycycline but recurred 4 days ago. The patient takes no medications. He is sexually active with one male and one female partner; they use condoms inconsistently. Temperature is 36.8°C (98.0°F), pulse is 75/min, and blood pressure is 135/78 mm Hg. Nucleic acid amplification testing of a clean catch urine specimen is positive for Neisseria gonorrhoeae and negative for Chlamydia trachomatis.  Which of the following is the most likely reason for the recurrence of infection in this patient?

Quizplus · Accepted Answer

Eductional Objective: Neisseria gonorrhoeae has high antigenic variability of surface molecules (eg, porins, Opa proteins, lipooligosaccharide), which prevents the formation of protective immunity and leads to susceptibility to repeat infection.

A 32-Year-Old Man Comes to the Physician Because of Severe