Etiology and Diagnosis

The causative agent of gonorrhea is the gonococcus (N. gonorrhoeae) - a small, diplococcus whose flattened apposing surfaces, tinctorial properties (when stained by Gram's method), and association with polymorphonuclear leukocytes provide a typical microscopic picture. In certain sites (e.g., urethra, joint, cerebrospinal fluid, ocular conjunctiva), demonstration of the typical morphology is virtually diagnostic. From other sites (rectum, pharynx), however, the possible presence of other gonorrhea types renders the Gram-stained smear less sensitive. For all sites, culture of the organism on artificial media is required for diagnostic assurance. Confirmation requires typical morphology, demonstration of indo-phenol oxidase production, and the ability of the organism to metabolize glucose, but not fructose, maltose, sucrose, or mannitol.

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