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Gonococcal Urethritis


Presentation

  • A repeat urethral smear for gram stain should be taken to determine if urethritis is still present and retested for urethral pathogens.[sahealth.sa.gov.au]
Inguinal Lymphadenopathy
  • In men, gonococcal infection most frequently gives rise to acute anterior urethritis with very typical symptoms including a greenish yellow purulent discharge from the genitals, edematous meatitis, dysuria and sometimes inguinal lymphadenopathy, but no[therapeutique-dermatologique.org]
Asymptomatic
  • Infected subjects may be totally asymptomatic.[therapeutique-dermatologique.org]
  • Since more than one half of men with gonococcal urethritis (30) and one third of men with chlamydial urethritis (31) may be asymptomatic, a urethral Gram stain and studies for detecting gonorrhea and chlamydia should be obtained even in the absence of[medical-dictionary.thefreedictionary.com]
  • Therefore, all symptomatic and asymptomatic ano-genital N. meningitidis infections should be treated with Ceftriaxone 500 mg IMI as a single dose (B1).[sahealth.sa.gov.au]
Inflammation
  • Also found in: Dictionary, Thesaurus, Encyclopedia. gonococcal urethritis Etymology: Gk, gone, seed, kokkos, berry, ourethra, urethra, itis, inflammation gonococcal urethritis Urethritis caused by Neisseria gonorrhoeae.[medical-dictionary.thefreedictionary.com]
  • If left untreated, infection may also give rise to complications including inflammation of the paraurethral glands and of Bartholin’s glands, salpingitis or even subacute pelvic peritonitis with an increased risk of infertility and ectopic pregnancy.[therapeutique-dermatologique.org]
Lymphadenopathy
  • In men, gonococcal infection most frequently gives rise to acute anterior urethritis with very typical symptoms including a greenish yellow purulent discharge from the genitals, edematous meatitis, dysuria and sometimes inguinal lymphadenopathy, but no[therapeutique-dermatologique.org]
Infertility
  • If left untreated, infection may also give rise to complications including inflammation of the paraurethral glands and of Bartholin’s glands, salpingitis or even subacute pelvic peritonitis with an increased risk of infertility and ectopic pregnancy.[therapeutique-dermatologique.org]
Pain
  • Gonococcal urethritis causes painful urination and discharge, although approximately 25% of men have no symptoms. 16] Our study showed higher incidence of gonococcal urethritis than nongonococcal compared with Kumar B et al and Chaudary SD et al.[medical-dictionary.thefreedictionary.com]
Pharyngitis
Dysuria
  • However, infection may also produce a picture of cervicitis causing a feeling of heaviness in the pelvic area and purulent leukorrhea often combined with urethritis expressed as urinary burning and dysuria.[therapeutique-dermatologique.org]
  • Patients with gonococcal urethritis usually had symptoms of both dysuria and discharge of short duration; patients with nongonococcal urethritis had variable symptoms of longer duration (P 0.0005).[annals.org]
  • Some men report only dysuria or discomfort without discharge. Urethritis can be classified as gonococcal or non-gonococcal urethritis (NGU), or non-specific urethritis (NSU), when no specific pathogen is identified.[sahealth.sa.gov.au]
Urethral Discharge
  • Culture of urethral discharge or endourethral swab samples on chocolate agar (Thayer-Martin, Isovitalex) with or without antibiotics is the test of reference.[therapeutique-dermatologique.org]
Salpingitis
  • If left untreated, infection may also give rise to complications including inflammation of the paraurethral glands and of Bartholin’s glands, salpingitis or even subacute pelvic peritonitis with an increased risk of infertility and ectopic pregnancy.[therapeutique-dermatologique.org]

Workup

Neisseria Gonorrhoeae
  • Neisseria gonorrhoeae is a species of Gram-negative, strictly aerobic diplococci bacteria that shows particular tropism for the glandular column-type cells of the endocervix and the urethra.[therapeutique-dermatologique.org]
  • Also found in: Dictionary, Thesaurus, Encyclopedia. gonococcal urethritis Etymology: Gk, gone, seed, kokkos, berry, ourethra, urethra, itis, inflammation gonococcal urethritis Urethritis caused by Neisseria gonorrhoeae.[medical-dictionary.thefreedictionary.com]
Chlamydia
  • Since more than one half of men with gonococcal urethritis (30) and one third of men with chlamydial urethritis (31) may be asymptomatic, a urethral Gram stain and studies for detecting gonorrhea and chlamydia should be obtained even in the absence of[medical-dictionary.thefreedictionary.com]
  • NGU is most commonly caused by Chlamydia trachomatis or Mycoplasma genitalium.[sahealth.sa.gov.au]
Chlamydia Trachomatis
  • NGU is most commonly caused by Chlamydia trachomatis or Mycoplasma genitalium.[sahealth.sa.gov.au]

Treatment

  • Treatment for tysonitis is similar to treatment for gonococcal urethritis and centers on the use of appropriate antibiotics. gonorrhoeae ciprofloxacin, penicillin, and tetracycline resistance among men with gonococcal urethritis (3).[medical-dictionary.thefreedictionary.com]
  • Our findings do not support routine use of erythromycin for treatment of pregnant, penicillin-allergic patients. ( JAMA 238:1371-1373, 1977)[jamanetwork.com]
  • These findings provide a basis for the rapid differential diagnosis of urethritis, which will permit immediate, definitive treatment for most men with urethritis. FULL TEXT[annals.org]
  • Back to top Treatment Antibiotic treatment should not be commenced until urethral swabs have been taken. First line treatment - Doxycycline 100 mg orally twice a day for 7 days (D).[sahealth.sa.gov.au]

Epidemiology

Sex distribution
Age distribution

Prevention

  • Acknowledgement: with thanks to Melbourne Sexual Health Centre Back to top Disclaimer These guidelines are based on review of current literature, current recommendations of the United States Centres for Disease Control and Prevention, World Health Organization[sahealth.sa.gov.au]

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