Gonorrhea: diagnosis by gram stain in the female adolescent.

The Gram-stained smear of secretions in female children and adolescents was evaluated as a diagnostic aid in acute gonorrhea. A positive smear was defined as the presence of at least eight or more pairs of Gram-negative, kidney-bean-shaped diplococci in each of at least two polymorphonuclear leukocytes. When the Gram-stained smear was compared with culture results in female patients it detected two thirds of infections and had a very high specificity. When the smear was positive, the culture was positive in 96% of the cases. The Gram-stained smear of cervical secretions is recommended as a guide to the early diagnosis of gonorrhea and its prompt therapy in the pediatric age group.