Serodiagnosis of gonorrhea

Due to the short incubation period of gonorrhea and the persistence of antibodies for years, a serological test cannot be used as the only basis for diagnosis of acute cases or for screening purposes. Major potential fields for application are the diagnosis of complicated gonococcal infections, casefinding in "high risk" groups and sero-epidemiological studies in developing countries. Serological tests using gonococcal pili antigen seem to be superior with regard to specificity.     

淋病证治

目的:总结作者辨证论治淋病的经验。方法:以医案形式阐述淋病的病因病机、证型、治法、方药。结果:淋病病因病机为房室不洁,触染邪毒,湿热淋毒聚结下窍,膀胱气化不利,清浊不分形成湿热毒蕴证;肝郁气滞,触染淋毒或湿热淋毒久蕴下焦,影响气血运行,败血浊瘀壅阻尿路精道形成气滞血瘀证;失治误治,久治不愈,余毒不解,耗气伤津,肝肾阴虚形成正虚毒恋证。治法:解毒化浊,清热利湿,行气活血,滋阴降火。结论:辨证论治淋病疗效显著。     

The modern diagnosis of gonorrhea

Modern identification of Neisseria gonorrhoeae may be either accomplished by direct detection of gonococcal antigen, i.e. without microbiological culturing, or, following culturing, by rapid culture confirmation. The direct detection of gonococcal antigen in an enzyme immuno-assay (Gonozyme) shows reduced specifity especially with mixed microbial flora, and decreased sensitivity with small numbers of organisms. Culture confirmation may be achieved by a rapid sugar degradation test (API----quadFERM+), by specific enzyme detection using chromogenic substrates (Gonochek II), or by demonstration of protein I specific for Neisseria gonorrhoeae by means of monoclonal antibodies (Mikrotrak, Phadebact monoclonal GC, Gonogen II). Detection of protein I is highly sensitive and specific in both the tests of immunofluorescence and coagglutination.     

Epidemiological correlates of asymptomatic gonorrhea

OBJECTIVES: To assess correlates of asymptomatic gonorrhea among patients attending Genitourinary Medicine Clinics participating in the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) in England for 2001-2003. STUDY DESIGN: GRASP is a sentinel surveillance program that monitors antimicrobial resistance to Neisseria gonorrhoeae. Data collection occurs annually in June to August each year. RESULTS: Women with previously diagnosed gonorrhea had decreased odds of asymptomatic gonococcal infection, as did women diagnosed with other sexually transmitted infections (all except chlamydia, syphilis, herpes, and warts). Heterosexual men, but not women, coinfected with chlamydia had significantly higher likelihood of being diagnosed with asymptomatic gonorrhea, as did homosexual men coinfected with syphilis and warts. CONCLUSION: The heterogeneity in correlates of asymptomatic gonorrhea has implications for screening in clinical settings. Such findings also depend on the extent of testing on sexually transmitted infections from different sites of infection, which has particular relevance in homosexual men and would thus need to be investigated in other studies.     

Co-occurrence of chancroid and gonorrhea

BACKGROUND: Gonorrhea and chancroid are common sexually transmitted infections in many parts of the world. Still, co-occurrence of these two conditions is uncommonly reported. OBJECTIVE: We present here a patient who presented with painful genital ulcers and urethral discharge simultaneously acquired from a single exposure, which turned out to be chancroid and gonorrhea, respectively. Both conditions responded well to a single intramuscular dose of ceftriaxone 250 mg. CONCLUSION: This report describes the uncommon occurrence of gonorrhea and chancroid in a patient. Clinical features, relevant investigations, treatment options of these two sexually transmitted infections, and possible implications in view of the human immunodeficiency virus (HIV) pandemic are briefly discussed.