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Related Experiment Videos

The 'borderline' smear in men with urethritis.

A J Arnold, G S Kleris

    JAMA
    |July 11, 1980
    PubMed
    Summary

    Microscopic examination of urethral exudate for gonorrhea can be borderline. Patients with borderline results should be treated for nongonococcal urethritis with tetracycline hydrochloride, not penicillin.

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    Area of Science:

    • Urology
    • Microbiology
    • Infectious Diseases

    Background:

    • Urethritis is a common condition in men.
    • Accurate diagnosis of gonorrhea is crucial for effective treatment.
    • Microscopic examination of urethral exudate is a primary diagnostic tool.

    Purpose of the Study:

    • To evaluate the clinical significance of "borderline" results in Gram stain for diagnosing gonorrhea.
    • To determine the appropriate treatment for urethritis cases with borderline Gram stain findings.

    Main Methods:

    • Microscopic examination of stained urethral exudate slides from 403 men with urethritis symptoms.
    • Culture of urethral exudate to confirm Neisseria gonorrhoeae presence.
    • Analysis of culture results for slides with "borderline" Gram stain findings.

    Main Results:

    • 14.1% of slides showed "borderline" Gram stain results (extracellular Gram-negative diplococci).
    • Only 10.5% of these "borderline" cases were culture-positive for Neisseria gonorrhoeae.
    • A significant proportion of "borderline" slides did not represent gonorrhea.

    Conclusions:

    • "Borderline" Gram stain results for gonorrhea in urethritis are often false positives.
    • Patients with urethritis and "borderline" Gram stain findings should be treated for nongonococcal urethritis.
    • Tetracycline hydrochloride is recommended over aqueous penicillin G procaine for these cases.

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