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To the Editor.—
With regard to the Gram's stain used for the diagnosis of Neisseria gonorrhoeae infection in men mentioned by Riccardi and Felman, I have found this method to be reliable and pass along a useful hint that has increased the yield and confidence that can be placed in the diagnosis of N gonorrhoeae infection on Gram's stain of the male urethral discharge.Often the patient will have urinated or be in the earliest stages of the disease when he is first seen, and a false-negative result can be found on Gram's stain of the direct smear. When the Gram's stain of the direct smear is negative, but the history and symptoms support a high suspicion for infection with N gonorrhoeae, we now do a Gram's stain of the spun urine specimen. The results of this have frequently been positive for Gram-negative intracellular diplococci; this eliminated the need for
Carlyle DC. Diagnosis of Gonorrhea. JAMA. 1980;244(3):238. doi:10.1001/jama.1980.03310030014008
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