How to make the diagnosis of rectal gonorrhea in men.

A simple quick method of diagnosing male rectal gonorrhea, applicable to office practice, is described using conventional staining techniques and microscopy. Photomicrographs of clinical smears serve as a guide line to practitioners. Neigon Jembec plates proved superior to Transgrow media for the culturing of isolates from 100 patients who had shown gram-negative diplococci at the initial microscopic investigation. Heretofore, lack of standardized diagnostic techniques have left male rectal gonorrhea a seldom recognized potential reservoir of infection.

Laboratory diagnosis in the problem of suspected gonococcal infection.

Proper laboratory techniques are indispensable for the diagnosis and detection of gonorrhea. While the smear is efficacious in diagnosing symptomatic urethral gonorrhea in men, it is not reliable for cervical, rectal, pharyngeal, or asymptomatic urethral infection. We have seen the development of four systems of culturing geared toward the office practitioner or where a complete laboratory is not available. They are as follows: Transgrow (transport), Neigon JEMBEC (transport or nontransport), Isocult, and Microcult systems. The Neigon JEMBEC system offers a good choice for the office practitioner. The use of proper diagnostic and culturing techniques and routine screening should bring about an increase in the amount of gonorrhea detected, treated, and subsequently removed from the reservoir of infection.

The utility of anoscopy in the rapid diagnosis of symptomatic anorectal gonorrhea in men.

Thirty-nine homosexual men seeking treatment for symptomatic proctitis were examined for anorectal gonorrhea by study of gram-stained smears obtained via an anoscope and by a blindly obtained anorectal swab specimen. Anorectal specimens for culture were obtained from all men. The sensitivity of the anoscopically obtained smears was 79% as compared with 53% for the blindly obtained smears. It was concluded that gram-stained smears obtained through an anoscope can provide rapid diagnosis of most cases of symptomatic anorectal gonorrhea. All patients with symptomatic proctitis should have routine anoscopy and examination of gram-stained smears obtained via anoscopy as part of their diagnostic evaluation.