Asymptomatic Gonorrhea in Men

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Abstract
Urethral gonococcal infection was detected in 40 per cent of asymptomatic male contacts of women with symptomatic gonorrhea. Culture was more sensitive than fluorescent antibody or Gram-stained smears in detecting asymptomatic genital infection in men, and Neisseria gonorrhoeae was detected more often in the anterior urethra than in prostatic secretions by all three methods. Among 28 asymptomatically infected men followed without treatment for seven to 165 days, 18 remained asymptomatic carriers of N. gonorrhoeae. N. gonorrhoeae was cultured from 59 (2.2 per cent) of 2628 sexually active United States Army enlisted men undergoing routine examinations, and 68 per cent of the infected men were asymptomatic. Asymptomatically infected men constitute a definite reservoir of N. gonorrhoeae, and a major factor in the current gonorrhea pandemic is the failure of physicians to identify and treat asymptomatic male contacts of women with gonorrhea that is either symptomatic or detected by routine culturing. (N Engl J Med 290:117–123, 1974)