Some observations on the diagnosis of rectal gonorrhoea in both sexes using a selective culture medium.

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Abstract
Utilizing a modification of the Thayer-Martin selective culture medium for gonococci (incorporating a nutrient agar with 10% hydrocele fluid and 10 units/ml Polymyxin B) rectal smears and cultures were made from 186 male and female gonorrhea contacts. Positive rectal cultures (33) outnumbered positive rectal smears (22) in the females but were fewer in the males (30 compared to 40). In 42% of the females and 44% of the males a laboratory diagnosis of rectal gonorrhea was made. Of the 14 females found to have persistent gonorrhea following treatment, 71% showed laboratory evidence of rectal gonorrhea post-treatment. Rectal gonorrhea requires a larger dose of penicillin for adequate treatment than does urogenital gonorrhea, possibly because the concentration of penicillin in the rectum is not high and its action may be impaired by the penicillinase produced by intestinal organisms. A dosage of 2.5 million units of Triplopen (Glaxo), a penicillin preparation, the composition of which is not stated is recommended.

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