Which organism is commonly found intracellularly in female genital tract smears and can be mistaken for normal flora?

• A. Neisseria lactamica
• B. Neisseria gonorrhoeae
• C. Neisseria meningitidis
• D. Neisseria sicca

Answer: (B)

Intracellular Gram-negative diplococci in neutrophils from a female genital tract smear are a classic clue for gonorrhea. Neisseria gonorrhoeae is known to invade neutrophils during infection, so finding these bacteria inside white blood cells strongly points to this organism rather than to typical nonpathogenic flora that usually lie outside cells. Smear appearance alone can be a rapid indicator, but confirmation with culture on selective media or a nucleic acid test finalizes the diagnosis. While other Neisseria species can resemble normal flora, their presence inside neutrophils in this context most strongly implicates Neisseria gonorrhoeae.