Diagnosis of gonorrhea by gram-stained smears and cultures in men and women: role of the urethral smear.

A retrospective study of the diagnosis of gonorrhea by gram-stained smear and culture was made. Of 1,681 men with gonococcal urethritis, 1,437 (85.5%) were positive by both smear and culture; 151 (9%), by smear alone; and 93 (5.5%), by culture alone. Of 1,148 women with gonorrhea, 742 (64.6%) had infection in both the cervix and urethra; 307 (26.7%), in the cervix alone; and 99 (8.6%), in the urethra alone. Of 1,049 cases of cervical gonorrhea, 461 (43.9%) were positive by both smear and culture; 67 (6.4%), by smear alone; and 521 (49.7%), by culture alone. Of 841 cases of urethral gonorrhea, 394 (46.8%) were positive by both smear and culture; 43 (5.1%), by smear alone; and 404 (48%), by culture alone. Cervical and urethral smears together gave a presumptive diagnosis in 709 (61.8%) cases, thus enabling early treatment to be instituted; 181 cases (15.8%) of gonorrhea in women were diagnosed solely by urethral smears.