Rectal gonorrhoea in men -- is microscopy still a useful tool?
D Grover1, K P Prime, M V Prince
1Department of Genito-Urinary Medicine, Mortimer Market Centre, Camden PCT, London WC1E 6AU, UK. deepa.grover@camdenpct.nhs.uk
International Journal of STD & AIDS
|April 6, 2006
Summary
Rectal microscopy for gonorrhoea (GC) in men aids immediate diagnosis. This method increased the number of men treated for rectal GC during their initial clinic visit, improving timely management.
Area of Science:
- Microbiology
- Sexual Health
- Public Health
Background:
- Rectal gonorrhoea (GC) diagnosis is challenging due to poor symptom correlation.
- Current gold standard, Neisseria gonorrhoeae culture, provides delayed results.
- Gram staining offers high specificity but low sensitivity for rectal GC.
Purpose of the Study:
- To audit the impact of rectal microscopy on diagnosing and treating rectal GC at initial presentation.
- To assess if rectal microscopy increases the proportion of men treated for rectal GC during their first visit.
Main Methods:
- A 12-month audit at an inner London genitourinary clinic.
- Review of 136 episodes of rectal GC in 132 men.
- Analysis of rectal microscopy results and treatment initiation.
Main Results:
- Rectal microscopy was performed in 134 of 136 cases (98.5%).
- 35% (47/134) of rectal smears were positive for GC.
- 27% (24/90) of treated patients would have delayed treatment without microscopy.
Conclusions:
- Rectal microscopy is a valuable tool for the rapid diagnosis of rectal gonorrhoea.
- Implementing rectal microscopy increases the number of men treated for GC at their first attendance.
- This diagnostic approach improves timely management of rectal gonorrhoea in men.
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