Gonococcal anogenital infection

Gonorrhea has become the most commonly reported disease, with an estimated prevalence of two and a half million cases. The incidence has risen markedly in the past decade. The degree to which this increase may be evident to the individual physician depends upon: the age and sexual habits of the population served, since promiscuity clearly plays a major role in the acquisition of the disease; how attuned the physician is to the diagnosis since it is often asymptomatic, especially in women; the diagnostic techniques at the physician's disposal because the causative organism is fastidious. This review outlines a practical clinical approach to the diagnosis and treatment. Gynecologists should include in their screening procedures of sexually active women (especially those active with multiple partners) a routine culture for gonorrhea at the time of the annual pap smear and other examinations. Although such screening has yielded a variable rate of detection, in specific groups the benefit justifies the cost. Only with increased attention to diagnosis, contact tracing, treatment, and education is there hope of controlling this disease.