An endocervical swab was collected from a 26-year-old woman with a purulent discharge. The Gram stain revealed the following: • Many white blood cells (WBCs) • Moderate gram-negative diplococci • Moderate gram-negative coccobacilli • Few yeast Based on these findings, what would be the next course of action?
a. Report the isolation of Neisseria gonorr-hoeae.
b. Work up the yeast.
c. Report the Gram stain, and follow up with culture.
d. Request a new specimen; this one is con-taminated.
C
Because the normal vaginal and rectal flora are composed of gram-negative coccobacilli, which can resemble Neisseria spp., the direct examination of endocervical secretions in symptomatic women is the only presumptive evidence of gonorrhea; therefore the diagnosis must be confirmed by culture.
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