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Six cases of gonococcaemia seen at the University Hospital of the West Indies are described. All presented with polyarthritis and all but one had skin lesions. They varied widely in severity and chronicity and included one case with rigors and myocarditis. Emphasis is placed on the diagnostic value of the scanty skin lesions, and the importance of repeated examination of cervical swabs. [ABSTRACT FROM PUBLISHER]

Diagnostic methods for Neisseria gonorrhoeae infections are surveyed with special emphasis on culturing on Thayer-Martin selective medium. The sensitivity and reproducibility of the culture method as well as suggestions regarding the optimal technique for obtaining and handling culture specimens are discussed. The problems of developing resistance to antibiotics are considered in the review of therapy. Current U.S. Public Health Service recommendations for diagnostic methods and treatment of N. gonorrhoeae infections are included. [ABSTRACT FROM AUTHOR]

The article examines the effectiveness of paramedical personnel in replacing the physicians in the venereal disease clinics in the U.S. The need for replacement was established by cost cutting reasons and difficulty in hiring physicians. A simultaneous study gonorrhea patients who were attended by doctors and paramedical staff was conducted. It was revealed that paraprofessionals had experienced error in diagnosis. The author recommended that they should be limited to only gonorrhea male patients, and in the case of a negative diagnosis, the patient should be examined by a physician.

Editorial. Comments on the serologic detection of gonorrhea. Use of complement-fixation or hemagglutination-inhibition reaction; Reliance of syphilis serology on flocculation and indirect fluorescent antibody testing; Origin of the concept of gonococcal serology.

This article presents a case report from a hospital which stressed the usefulness of external ear canal material in the diagnosis of neonatal sepsis acquired in utero. This case illustrates the use of culture material from the external ear canal in diagnosing gonorrheal colonization of a newborn and gonorrheal infection in the mother.

Three serological tests used in the diagnosis of gonococcal infection were compared with cultural techniques in 857 females attending the Prenatal and Gynaecology Clinics at the Winnipeg General Hospital. The tests evaluated were the microflocculation technique (MFT), the indirect fluorescent-antibody technique (IFAT), and the complement-fixation technique (CFT). One hundred six patients had positive cultures for Neisseria gonorrhoeae. In this population, the MFT was reactive in 80 patients (75.4%), the IFAT was reactive in 74 (69.8%), and the CFT was reactive in 33 (31.1%). In the 751 patients with negative cultures, the MFT was positive in 11.4%, the IFAT was positive in 17.4%, and the CFT was positive in 10.5%. Sera from 9 of 10 patients with gonococcal arthritis were positive with the MFT.

In a prospective study, 133 male contacts of 102 women with gonorrhea were examined. A diagnosis of gonorrhea was made in 63 patients, indicating an infection rate of 47% after exposure. Forty-three percent of the patients with gonorrhea were asymptomatic. The duration of the asymptomatic period ranged from 3 to 154 days. The epidemiologic importance of this hidden infectious reservoir is stressed.

When Candida albicans is present on Transgrow specimens, Neisseria gonorrhoeae is detected less frequently or else can be seen in Gram stains but cannot be readily cultured. When C. albicans and N. gonorrhoeae are grown together on Transgrow, the gonococcal cells die off much more readily than N. gonorrhoeae grown on Transgrow alone. By use of a cross-streaking technique on agar plates, it has been demonstrated that C. albicans produces a soluble substance inhibitory to N. gonorrhoeae, although not to other microorganisms tested. Preliminary results indicate that this inhibitory factor can be extracted by the use of tertiary butanol. Since approximately one-third of the Transgrow specimens with growth contains yeasts, of which C. albicans is by far the most frequent, this factor presents an important complication in the diagnosis of gonorrhea in women.