What is the role of cultures in the diagnosis of gonococcal arthritis?

Updated: Jul 31, 2018
  • Author: Rachel Robbins, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Yield is highest if the culture is obtained from the primary infection site. Findings are positive in more than 80% of cases. When obtained from the primary site of infection, 90% of results are positive in cervical samples, 50-75% in male urethral samples, 20% in pharyngeal samples, and 15% in rectal samples. [1]

The pharynx is an important site of infection in pregnant women and in men who have sex with men. For a rectal culture, the swab is inserted approximately 2.5 cm into the canal (ie, to the crypts of Morgagni, a frequent focus of infection). Mucosal surface cultures should be placed on prewarmed selective plates (ie, Thayer-Martin or modified New York media) and blood agar for identification of other possible organisms.

Urine culture is noted to produce a higher yield if the sample is the first-void urine from the first 20 mL of the void.

Bottled blood culture media containing sodium polyethylene sulfate inhibits growth.


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