Some of the diagnostic procedures for uncomplicated urogenital and rectal gonorrhea were studied in a university-based venereal disease clinic. On the basic of our results, recommendations are made concerning the types of media to be used, sites to be sampled, methods of obtaining specimens, and other diagnostic considerations. We conclude that ongoing quality control including a review of diagnostic procedures should be carried on in all venereal disease clinics.
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.
Thirty-six patients having granuloma inguinale were treated at the 483 USAF Hospital, Cam Ranh Bay, Republic of South Vietnam between October 1970 and September 1971. In 24 cases biopsy of the genital ulcerations revealed Donovan bodies pathognomonic for the disorder. The lesions generally did not heal during tetracycline therapy. All but 2 of the 31 cases treated primarily with ampicillin responded with complete healing of the local lesions which occurred primarily on the penis or in the groin. Of the remaining 2 patients, one responded to a second course of ampicillin and the other patient responded to a two week course of lincomycin after dorsal slit had been performed for partial phimosis and balanoposthitis. The 5 patients who were allergic to penicillin were treated primarily with lincomycin and all responded with complete healing. No previous reference could be found in the literature for the successful use of lincomycin in patients with granuloma inguinale. Further clinical trials with this medication are indicated.
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