Reading and Reporting Direct Smears

Special Considerations for Genital Smears

  • Gram negative cocci which occur in pairs with their adjacent sides flattened, giving them a coffee bean appearance, are typical of the genus Neisseria. Neisseria gonorrhea is commonly found within white blood cells; these organisms must be carefully sought within genital tract specimens, and their presence or absence should be specifically noted in the report.
  • The presence of intracellular gram negative diplococci in a purulent male urethral smear is presumptive evidence of gonococci, but this assumption cannot be made in a female.
  • Beware of other organisms which resemble gonococci but are found extracellularly, such as Acinetobacter lwoffi, which must be distinguished biochemically.
  • Direct smears read specifically for the presence of gonococci should include a direct reference to gram negative intracellular diplococci.

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