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September 14, 1935


JAMA. 1935;105(11):862-864. doi:10.1001/jama.1935.02760370018007

In cases of children suffering from vulvovaginitis, the first question is whether or not it is a gonorrheal infection. The clinical picture of this infection is not typical enough to allow a diagnosis to be made without a bacteriologic examination. The diagnosis is almost always made on smears of the pus stained by Gram's method or only with methylene blue. Cultures are not considered necessary. As there are some cocci that resemble the gonococci more or less when different staining methods are used, the way to a faulty diagnosis is open. Clauberg1 pointed out that many cases of vulvovaginitis were falsely considered gonorrheal infections. From seventy children with vulvovaginitis he could not cultivate gonococci. Gradwohl1a cultivated gonococci in only two out of twenty-five cases. As I had found the ascites-Levinthal-agar plates and bloodwater-agar plates excellent mediums for the isolation of gonococci, I tried to find out which part