Diagnosis of gonorrhea in women--Influence of the contraceptive pill.
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Biomedical subjects
Publications and source records attributed to A E Jephcott.
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A non-toxigenic strain of Corynebacterium diphtheriae var. gravis was isolated from 31 boys during an outbreak of sore throats at a boarding school of 15 staff and 134 pupils. Despite the non-toxigenicity of the strain involved, conventional isolation procedures were observed and all boys at the school were treated with antibiotics. Restrictions on the school were only relaxed when no further carriers were detected. The rationale of such management of an episode involving a non-toxigenic strain is discussed.
The apparent increase in the incidence of opportunist mycobacterial pulmonary infection is assessed. The clinical, bacteriological and radiological characteristics of 34 cases of such infections seen over a period of ten years in Sheffield are reviewed. The typical radiological appearances consisting of cavities, fibrosis and opacities are described and illustrated. There has been in the past conflicting reports on the specificity of such radiological features; it is concluded that although such appearances are not pathognomonic, their presence should arouse suspicion of such an infection and this should be confirmed or refuted by bacteriological investigations.
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A total of 250 women, 100 of them named contacts of men with gonorrhoea, were tested for infection. Each had prepared smear and culture specimens from urethra, endocervix, and vagina. The smears were Gram-stained and examined immediately. Cultures were taken using Stuart's transport medium with later inoculation of both selective and non-selective media for each specimen.It was shown that examination of specimens from urethra and endocervix gave results superior to those found on examination of vaginal material alone. The study revealed that nearly one infected woman in three would have been missed if vaginal material only had been examined. Failure to secure a prompt scientific diagnosis has serious epidemiological implications.Our results find support in the work of others. We conclude that the suggestion in some quarters that examination of vaginal material for the detection of gonococci is adequate should be abandoned. Any who feel unwilling to accept this view should at least supplement their testing with examination of urethral and endocervical specimens.
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