
What Does Finding Of Gram Negative Diplococci On Urethral Smear Indicate?

Is there any possibility of a misdiagnosis, false positive, etc? I'm just baffled and would like some advice....attached the swap test results for your review....how I can know am cured by this with the course of my medicine...thanks
The test report does not suggest gonorrhea
Detailed Answer:
Hello. Thank you for writing to us
I have reviewed your recent discussions with other doctors on panel of healthcaremagic regarding possibility of Hiv and Gonorrhea from genital rubbing.
I have also reviewed the test report that you have attached with this query.
Gonorrhea is a gram -ve cocci and on smear made from urethral discharge the organism appears as gram -ve diplococcus (in pairs), within polymorphonuclear leukocytes/ pus cells.
This finding of gram -ve diplococci on urethral smear is diagnostic of gonorrhea.
However, in the smear made from urethral discharge shows gram +ve cocci which is most likely to be staph. aureus rather than gonococcus.
The smear also reveals gram -ve bacilli which could be E. coli or other similar organisms.
Going by this test report you don't have gonorrhea.
-Were any other tests performed before labeling the diagnosis as gonorrhea?
-Did you had any symptoms like burning on passing urine? Pus discharge from urethra?
Nowhere in your previous discussions with other esteemed doctors on panel of healthcaremagic I could find that you even complained of urethral discharge.. so why was this test even done?
Regards


This test rules out gonorrhea
Detailed Answer:
Hi
No, as per the attached report you don't have gonorrhea.
The report otherwise detects gram +ve cocci and gram -ve bacilli on smear, which could be just contaminants during sample collection.
You may continue with the prescribed antibiotic course for full duration instead of leaving it midway, however, most likely the organisms on smear are just contaminants.
None of these organisms are transmitted through sexual contact.
Considering the nature of sexual encounter and the test report you don't seem to have an STD.
However, just to be on the safer side of things, you may take up an HIV test at 4 weeks after sexual contact and ELISA for type 1 and type 2 herpes, also at 4 weeks after sexual contact.
Regards


Likely a UTI rather than gonorrhea
Detailed Answer:
Hi.
I have reviewed urine routine microscopy report. Pus cells and RBC's are raised above normal.
This report suggests that there might be a UTI (urinary tract infection) which is probably the cause of your symptoms like burning on passing urine.
However, going by the smear report you don't have gonorrhea.
In gonorrhea there is XXXXXXX pus discharge per urethrum and there is lot of burning and pain on passing urine.
Moreover, the smear should have shown as gram -ve diplococci on smear, which it strikingly did'nt. We cannot diagnose gonorrhea despite complete absence of gram -ve diplococci.
The oral antibiotic that you have been prescribed (cipro) would take care of UTI.
Once you complete your antibiotic course I suggest a repeat urine microscopy to ascertain that everything is fine.
Regards


Feel free to ask more questions
Detailed Answer:
Hi.
I have gone through your previous discussions with other doctors on healthcaremagic i.e Dr. XXXXXXX Dr, XXXXXXX and Dr, bharatesh..
In all these discussions none of the doctors themselves diagnosed you as gonorrhea... though you yourself seem to tell them that you have been infected with gonorrhea...probably you got this diagnosis somewhere outside of this forum.
I have excluded gonorrhea solely on the basis of smear that was made from urethral discharge.
Unless one sees intracellular gram -ve diplococci on smear we cannot say with firm conviction that this was indeed gonorrhea.
Yes, you can surely take another opinion.. I would recommend Dr. XXXXXXX
Regards

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