How to Make Diagnosis of Gonorrhea

       Diagnosis of gonorrhea is based on the results of microscopic examination of pus or duh to find the bacteria that causes gonorrhea. If the microscopic examination of bacteria is not found, then performed in a laboratory culture.
Diagnosis is made on the basis of anamnesis, clinical examination, and investigations which consists of 5 stages.

A. direct preparations
With the use of staining gram will be found Gonococcus bacteria, gram negative, intracellular and extracellular. Duh materials in men's body was taken from navikularis fossa region, while the woman was taken from the urethra, Bartholin's glands of the mouth, cervix, and rectum.

B. culture
For identification, breeding is required (culture). Two kinds of media that can be used are:
1. media transport
2. growth media
Examples of transport media are:
• Media Stuart
Just to transport it, so it needs to be planted back on the growth media.
• Media Transgrow
This media is selective and nutritive for N.gonorrhoeae and N.meningitidis, the trip can last up to 96 hours and is a combination of transport media and growth media, so it does not need to be planted on growth media. This media is Thayer Martin medium modified by adding trimethoprim to kill Proteus spp.

Examples of growth media are:
• Mc Leod's chocolate Agar
That contains chocolate, for serum, and for hydrocele. In addition to Gonococcus bacteria, other germs can grow.
• Thayer Martin Agar Media
This selective media to isolate the Gonococcus. Containing vancomycin to suppress the growth of gram-positive bacteria, colistimethate to suppress the growth of gram-negative bacteria, and nystatin to suppress the growth of fungi.
• Modified Thayer Martin Agar
Contents coupled with trimethoprim to prevent growth of bacteria Proteus spp.

C. definitive test
1. oxidation tests
Oxidizing reagent solution containing p-phenylenediamine-tertrametil hydrochloride 1% was added to the colony suspect Gonococcus. All Neisseria gave a positive reaction to the changing color of the original colonies turned translucent pinkish red to violet.
2. fermentation tests
Oxidation tests positive, followed by fermentation tests using glucose, maltose, and sucrose. Gonococcus germ leaven only glucose.

D. Beta-lactamase test
Examination of beta-lactamase by using TM cefinase disc. BBL 961 192 containing the chromogenic cephalosporine, will cause a color change from yellow to red when the bacteria contain the enzyme beta-lactamase.

E. Thomson tests
Thomson useful test to determine the extent to which the infection is already underway. First inspection should be done because of treatment at the time of treatment is local.
In this test, there are conditions that need attention:
• Should be done after waking up
• Urine is divided into two glasses
• May not hold urine from glass to glass I II.
Necessary condition is that the bladder urine must contain at least 80-100 ml, if the urine is less than 80 ml, then the glass II considered difficult, because the new drain anterior urethra.

interpretation:
Glasses I       glass II     Meaning
Clear             Clear        No infection
Cloudy          Clear        anterior urethritis infections
Cloudy          Cloudy     Panuretritis
Clear             cloudy      impossible or negative

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