FOR years, the sine qua non of gonococcal infection in the male patient has been a thick, purulent urethral discharge and evidence of Gramnegative intracellular diplococci on smear examination. Indeed, these findings are used for presumptively diagnosing gonorrhea in males. Similarly for the female patient, an oxidase-positive colony that shows Gram-negative diplococci by microscopic examination is often accepted as a gonococcus without further investigation.
As early as 1939, attention was drawn to microorganisms that could invalidate the diagnosis of gonorrhea by the smear method. DeBord1 indicated such for Mima polymorpha (Moraxella osloensis), and in 1942 Carpenter and Charles2 reported the isolation of Neisseria meningitidis from gonococcal-like discharge in seven male patients. Little attention has been paid to N meningitidis until recent years. Since 1971, there have been reports of 80 patients in whom Nmeningitidis was isolated from the urethra, cervix, or anal canal.3,4
This article reports