Ultrastructural study of cervical gonorrhea.

An ultrastructural examination of the squamocolumnar junction of the cervix of patients infected with Neisseria gonorrhoeae is described. Gonococci were found to become firmly attached to stratified squamous epithelium, a process that appeared to be initiated by activity of the cytoplasmic membrane of superficial squames. By contrast, gonococci were not found attached to, or even closely associated with, mucus-secreting columnar epithelium. Gonococcal growth, as evidenced by numbers of organisms and surface vesicle formation, appeared most active in cervical secretions, chiefly on exfoliated squames, but also lying free. Survival after phagocytosis by polymorphonuclear leukocytes was found not to be unique to gonococci, and it is suggested that continual phagocytic recycling minimizes the significance of this occurrence. It seems probable that persistence of gonorrhea in the female depends upon the adherence of gonococci to stratified epithelium, where they are protected from phagocytosis, and the infectivity of gonorrhea arises from the ability of gonococci to divide rapidly on the surface of exfoliated squames, from where they are released into secretions.