The initial symptoms in women include a painful or burning sensation when urinating or an abnormal vaginal discharge. More advanced symptoms, which indicate progression to PID, include abdominal pain, bleeding between menstrual periods, vomiting, or fever. Men usually have a discharge from the penis and a burning sensation during urination that may be severe. Symptoms of rectal infection include discharge, anal itching, and sometimes painful bowel movements. Diagnosis Two techniques, gram stain and culture, are generally used to diagnose gonorrhea.
Many doctors prefer to use both tests to increase the chance of an accurate diagnosis.
The gram stain is quite accurate for men but less so for women. The test involves placing a smear of the discharge on a slide that has been stained with a dye and then examining it under a microscope for the presence of the gonococcus. Test results usually can be given to the patient at the time of an office or clinic visit. The culture test, the preferred method of diagnosing gonorrhea in women, involves placing a sample of the discharge onto a culture plate and incubating it for up to 2 days to allow the bacteria to multiply. The accuracy of this test depends on the site from which the sample is taken.