GONORRHŒA IN WOMEN

Examination of the case-notes of all women seen at a large metropolitan clinic during 1976 showed 607 episodes of gonorrhœa (92·3% of all such cases seen in the hospital), of which 3 were in prepubertal girls. Gonorrhœa occurred more often and at an earlier age in Negroids than in Caucasians. In about 30% of patients gonococci could be found in only one of the sites tested (cervix 18%, urethra 6%, rectum 4·8%, and throat 1·5%). Microscopical examination of gram-stained cervical and rectal samples was of value, but that of urethral samples made no significant contribution to the diagnosis. 31% of the gonococcal isolates showed diminished sensitivity to penicillin, but none showed significant resistance to spectinomycin, kanamycin, or sulphamethoxazole. The complication rate was lower than that reported from the United States. Overall, 40% of patients were symptom-free. The presence of other infection significantly increased the probability of a patient with gonorrhœa having symptoms. "Epidemiological" treatment would have led to the unnecessary treatment of 142 females and would have included only 4 of 16 patients with gonorrhœa who defaulted before treatment could be given.