Clinical spectrum of gonococcal infection in women

The medical records of 278 women infected with Neisseria gonorrhoeae during a 6-month period were reviewed. These represented 75% of the infections in women at Boston City Hospital during this time. Women who presented to the venereal-disease clinic because they had had contact with an infected man and women who were found to be infected during routine examinations in the obstetrics-and-gynaecology clinic were usually free of symptoms or had non-specific symptoms such as vaginal discharge. However, these women accounted for only 108 (39%) of the 278 infections. Most of the infections were in women who presented to the emergency-care areas of the hospital with symptomatic gonococcal infections. At least 86 (31%) of the 278 infections were in women who had pelvic inflammatory disease. These data indicate that the clinical spectrum of gonococcal infection varies according to where the patients are seen and that the widely held concept that most gonococcal infections in women are asymptomatic may be erroneous.