Microscopy of tonsillar smears and sections in tonsillar gonorrhoea

Microscopy of methylene-blue and Gram-stained smears from the tonsillar surface and an immunofluorescence (IF) test were carried out for 130 patients, 129 with genital and/or anal gonorrhoea, 27 of whom also had tonsillar gonorrhoea. One patient had only tonsillar gonorrhoea. 5 of the 28 patients with tonsillar gonorrhoea had acute tonsillitis and for these, agreement was found between culture, light microscopy and IF test, while only 5 of the remaining 23 patients had positive microscopy. Among the 102 patients who did not have tonsillar gonorrhoea a few false-positive light microscopies and IF tests were found. Microscopy of haematoxylin-eosin stained sections of 8 tonsils from 4 patients with recurrent tonsillitis and tonsillar gonorrhoea showed subacute tonsillitis. Methylene-blue and Gram-stained sections revealed gram-negative diplococci morphologically similar to gonococci. The bacteria were located in the superficial layers of the mucous membrane (frequently intracellularly in leukocytes) and occasionally in cellular debris in the crypts.