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Venereal diseases
Published in Dinesh Kumar Jain, Homeopathy, 2022
Gonorrhea is a bacterial infection caused by Neisseria gonorrhoeae, a Gram-negative coccus. Gonorrhea in a male is characterized by purulent urethral discharge, dysuria, and frequent urination. Other local complications are inguinal lymphadenitis, edema of penis, and abscess. In homosexual men, anorectal and pharyngeal infections are common. In female dysuria, frequent urination, increased vaginal discharge, anorectal discomfort, midline low abdominal pain, and tenderness are common symptoms in gonorrhea. “Before antibiotic treatment became available, symptoms of urethritis persisted for an average of 8 weeks and unilateral epididymitis occurred in 5 to 10% untreated men” (Holmes, 1983a, p. 940). In homosexual men symptomatology of gonorrhea, “may subside without treatment, leaving a chronic asymptomatic carrier state” (Holmes, 1983a, p. 940). “Symptoms gradually resolve without treatment but it is not known how long patients remain infectious, the longer patients remain without treatment the more likely they are to develop complications” (Griffin et al., 1999, p. 187). “Acute symptoms of gonococcal urethritis in the female may subside spontaneously” (Holmes, 1983a, p. 941).
Candida and parasitic infection: Helminths, trichomoniasis, lice, scabies, and malaria
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Colonization with T. vaginalis is asymptomatic in most males and initially in many females, but it is estimated that 50% to 90% of women with vaginal colonization will ultimately become symptomatic if left untreated (23). Symptoms in women include a profuse, malodorous, frothy, yellow-green vaginal discharge and vulval itching or burning. Males have symptoms consistent with non-gonococcal urethritis, including urethral discharge, local itching/burning, and pain with urination. Treatment of trichomoniasis is typically limited to drugs from the nitroimidazole family—metronidazole (single 2-g oral dose or 500mg orally BID × 7 days) and tinidazole (single 2-g oral dose) (50). Simultaneous treatment of all sexual partners prior to next sexual contact is recommended to prevent immediate recolonization. There has been some controversy over the legal status of providing trichomoniasis treatment to the patient to deliver to his/her partners in the absence of direct contact between the partners and the health-care system, but many U.S. states have now enacted legal protection for partner-delivered therapy for sexually transmitted diseases. Assessment of local standard of care and legal requirements is recommended prior to initiating a practice of partner-delivered therapy.
Infectious disease
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Gonococcal urethritis (gonorrhoea): caused by Neisseria gonorrhoeae (gonococcus). Rarely systemic infection affecting skin (petechiae, pustules) and joint (tenosynovitis, arthritis) is seen. Treatment: antibiotic therapy depends on local sensitivities but usually treatment is with a third generation cephalosporin (e.g. cefuroxime).
Clinical pharmacokinetics of cefixime: a systematic review
Published in Xenobiotica, 2023
Maria Ajmal, Ammara Zamir, Anees ur Rehman, Imran Imran, Hamid Saeed, Abdul Majeed, Majid Aziz, Faleh Alqahtani, Muhammad Fawad Rasool
The AUC was reported to be lower in patients undergoing haemodialysis (HD) as compared to those in continuous ambulatory peritoneal dialysis (CAPD) while in patients with mild, moderate, and severe renal impairment, the AUC and Cmax increased and tmax and CLR, values decreased. The percentage of the dose excreted in urine decreased as renal impairment worsened i.e. (creatinine clearance < 20 mL/min per 1.73 m2). In these cases, dose adjustments may be necessary to avoid toxicity (Guay et al. 1986). In the case of uraemic patients, the Cmax was higher in patients compared to healthy subjects after an oral administration of 200 mg (Dhib et al. 1991). In patients with T-tube drainage, the Cmax was 2.3 ± 0.85 (µg/ml) (Westphal et al. 1993). In patients with uncomplicated gonococcal urethritis, a two-fold increase in AUC was reported by doubling the dose of 200 mg (Deguchi et al. 2003) (Table 4).
Investigating the microbial pathogens of sexually transmitted infections among heterosexual Vietnamese men with symptomatic urethritis
Published in The Aging Male, 2022
Bac Hoai Nguyen, Quan Minh Pham, Long Hoang, Andrea Sansone, Emmanuele A. Jannini, Chau Minh Tran
In men, urethritis is mostly caused by STIs, expressing a diversity of signs and symptoms ranging from urethral discharge, itching, tingling, dysuria, but it can be asymptomatic in some cases [4,5]. Besides the well-known pathogens, such as Neisseria gonorrhoeae and Chlamydia trachomatis, other causative microorganisms have been studied but one-third of non-gonococcal urethritis is idiopathic [5,6]. Rather than empiric treatment, antibiotics use based on microbial evidence has been recommended to reduce the resistance phenomenon [4]. Since the etiology is different among countries and it is impossible to test all potential pathogens, studying microorganisms causing urethritis is required.
Knowledge, attitudes and practices of doctors at Jubilee Hospital, Tshwane District, regarding the syndromic management guidelines for sexually transmitted infections
Published in South African Family Practice, 2018
Charles Uchenna, Indiran Govender
These findings are supported by Schneider (1995), who assessed services for the control of sexually transmitted diseases in the Johannesburg, Pretoria and Vaal Triangle area, where 48.2% of the doctors interviewed indicated that they will treat for both gonococcal and non-gonococcal urethritis, or for the most likely causative organism, and routinely ask the patient to come back if symptoms persist. The remaining 51.8% indicated they will treat with only one drug or treat based on clinical diagnosis.20 Since one-quarter of gonococcal infections are clinically indistinguishable from non-gonococcal urethritis, it therefore means the above treatments are definitely inadequate.14