Gonorrhea: Diagnosis

The diagnosis of gonorrhea can be made at a public health clinic or a family physician office. First, the doctor will discuss symptoms and the patient's known contact or at-risk behavior. There are three methods available to test for the presence of Neisseria gonorrhoeae. These include a culture, a Gram stain, and an ELISA test. Culture of secretions from the infected area is the preferred method for gonorrhea screening in patients with or without symptoms. A cotton swab can be used to collect enough sample for a culture. The sample is incubated for up to two days, providing enough time for the bacteria to multiply and be accurately identified. This test is nearly 100% accurate.

Gram stains are more accurate in the diagnosis of gonorrhea in men than in women. To perform this test, a small amount of discharge from the infected area will be placed on a slide, stained with a special dye, and examined under a microscope for the presence of the gonococcus bacteria. The advantage to this test is that results can be obtained very quickly at the initial visit. Because it requires that the physician or technician to be able to recognize and accurately identify the bacteria simply by looking at it under a microscope, however, this test is only approximately 70% accurate. As a result, one of the other methods will also probably be used to confirm the diagnosis.

ELISA, or enzyme-linked immunosorbent assay, has emerged as a rapid and sensitive test for gonorrhea. It is much more sensitive than the gram stain and is more convenient than the culture test, which involves the transport and storage of samples. As of late 1997, several other diagnostic tests were being researched with the goal of providing a cost-effective method of screening for a variety of sexually transmitted diseases. One of the most interesting of these is a home test that can be taken by the patient themselves, allowing for a degree of privacy and confidentiality.

When a patient suspects exposure to or experiences symptoms of gonorrhea, he or she may see a public health provider or family practice physician. Physicians trained in obstetrics or gynecology may also be involved, particularly if gynecological complications occur. Men who experience complications may be referred to a urologist. There are also infectious disease doctors who specialize in the treatment and research of all infectious diseases, including those transmitted sexually. All doctors must report this highly contagious disease to public health officials, and patients are asked to provide the names of sex partners during the suspected period of infection so that they can be notified of the risk.

— Teresa G. Norris