Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects.

Examination of the case-notes of all women seen at a large metropolitan clinic during 1976 showed 607 episodes of gonorrhoea (92.3% of all such cases seen in the hospital), of which 3 were in prepubertal girls. Gonorrhoea occurred more often and at an earlier age in Negroids than in Caucasians. In about 30% of patients gonococci could be found in only one of the sites tested (cervix 18%, urethra 6%, rectum 4.8%, and throat 1.5%). Microscopical examination of gram-stained cervical and rectal samples was of value, but that of urethral samples made no significant contribution to the diagnosis. 31% of the gonococcal isolates showed diminished sensitiivty to penicillin, but none showed significant resistance to spectinomycin, kanamycin, or sulphamethoxazole. The complication rate was lower than that reported from the United States. Overall, 40% of patients were symptom-free. The presence of other infection significantly increased the probability of a patient with gonorrhoea having symptoms. "Epidemiological" treatment would have led to the unnecessary treatment of 142 females and would have included only 4 of 16 patients with gonorrhoea who defaulted before treatment could be given.