How useful are cultures and Gram stains in diagnosing gonococcal septic arthritis?
Unlike nongonococcal arthritis, the Gram stains of synovial fluid are positive in <25% in gonococcal arthritis. Cultures improve the diagnostic yield. Because urethritis is often asymptomatic, all patients should have a urine specimen as well as urethral/rectal/pharyngeal swabs sent for Gram stain, culture, and NAAT testing. Urethral smears and cultures are more useful in men (>90% sensitivity) than in women.
|Culture positivity in dGI|