Gram ⊝ diplococci. Metabolize glucose and produce IgA proteases. Contain lipooligosaccharides (LOS) with strong endotoxin activity. N gonorrhoeae is often intracellular (within neutrophils).

Meningococci- Polysaccharide capsule- Maltose fermentation- Vaccine (except type B due to mimicry)- Transmitted via respiratory and oral secretions and are able to colonize the nasopharnyx due to fimbriae, pili. Penetrate epithelium and enter bloodstream. Penetrate cerebral capillary endothelium or choroid plexus.- Causes meningococcemia with petechial hemorrhages and gangrene of toes, meningitis, Waterhouse-Friderichsen syndrome (adrenal insufficiency, fever, DIC, shock)- Treatment: Ceftriaxone or penicillin G

Gonococci- No polysaccharide capsule- Maltose not fermented- No vaccine due to antigenic variation of pilus proteins- Sexually or perinatally transmitted- Causes gonorrhea, septic arthritis, neonatal conjunctivitis, pelvic inflammatory disease (PID), and Fitz-Hugh-Curtis syndrome- Diagnosis: Nucleic acid amplification testing- Treatment: Ceftriaxone (+ azithromycin or doxycycline for possible chlamydial coinfection). Erythromycin eye ointment prevents neonatal blindness.