Systemic manifestations of gonococcal disease, such as arthritis, are often sterile on the usual culture methods used to grow gonococci. Allergic mechanisms have been invoked to explain this but with little evidence to support the concept. With the report by Holmes et al., that L-forms of gonococci were isolated from joint fluid of a patient with gonococcal arthritis, we decided to investigate the possible role of L-forms in gonococcal disease
