Single-site infection with Neisseria gonorrhoeae in homosexual men

To determine need to culture multiple anatomic sites of homosexual men, we examined 1803 cultures from 791 men who had positive cultures for Neisseria gonorrhoeae from one or more sites. The men were examined during fiscal year 1982 at a health center that serves the gay community. Not included are 184 patients who had positive cultures from the only site tested. Of the 607 patients cultured from two or more anatomic sites, 34 (5.6%) had cultures positive for N. gonorrhoeae from each site, and 492 (81.1%) had N. gonorrhoeae isolated from one site only. Of these 492 patients, 36 (7.3%) had positive cultures from the oropharynx only, 232 (47.2%) from the urethra only, and 224 (45.5%) from the anal canal only. Of 405 patients cultured from the urethra, anal canal, and oropharynx, 92 (22.7%) had N. gonorrhoeae at two or more sites; 313 (77.3%) had the organism at one site only. Of 84 patients cultured from the anal canal and oropharynx only, 11 (13.1%) had positive cultures from the oropharynx and negative cultures from the anal canal. Since it is highly improbable that the infected site will be selected if only one site is cultured, routine culturing of the urethra, anal canal, and oropharynx of homosexual men is necessary for accurate diagnosis.