Cul-de-sac isolates from patients with endometritis-salpingitis-peritonitis and gonococcal endocervicitis

Neisseria gonorrhoeae was cultured from the cul-de-sac in 11 of 17 patients with bacteriologically documented gonococcal endometritis-salpingitis and identified by Gram stain in one other instance. In five, N. gonorrhoeae was the only isolate. In six other patients, the presence of other aerobic (two) and anaerobic bacteria (three), as well as N. gonorrhoeae, was documented. In the remaining six patients, only aerobic and anaerobic organisms were isolated. The data are interpreted as supporting the concept of anaerobic superinfections following initial infection with N. gonorrhoeae late in the course of this disease entity.