Review reveals adaptive convergence and atypical tissue tropism across pathogenic Neisseria infections, highlighting the need to update clinical diagnosis and public health surveillance.
Key Points
To synthesize epidemiological, clinical, and genomic evidence detailing atypical infections caused by Neisseria meningitidis and Neisseria gonorrhoeae and identify the determinants of their altered pathogenesis.
Synthesized current clinical and epidemiological data on atypical presentations, including disseminated gonococcal disease, primary meningococcal conjunctivitis, and urogenital meningococcal infection.
Assessed whole-genome sequencing literature to evaluate evolutionary mechanisms, adaptive convergence, and determinants of tissue tropism across the Neisseria genus.
Genomic analyses indicate adaptive convergence between N. meningitidis and N. gonorrhoeae, leading to atypical anatomical presentations that challenge standard diagnostic assumptions.
Clinical evidence highlights significant under-recognition of primary meningococcal conjunctivitis and urogenital infections, hindering prompt intervention and targeted disease prevention.