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Urethritis
Published in Charles Theisler, Adjuvant Medical Care, 2023
Urethritis is inflammation and swelling of the urethra, the structure that transports urine from the bladder to the outside of the body. Pain or burning with urination is the main symptom of urethritis along with increased urinary frequency and/or urgency. The urethral opening is typically red due to inflammation. Urethritis can be caused by bacterial infections (e.g., Staphylococcus aureus or E. coli) and STDs (Neisseria gonorrhoeae, non-gonococcal urethritis, Chlamydia trachomatis, or Mycoplasma genitalium) and also by trauma or irritating chemicals (e.g., antiseptics or spermicides). In females, pelvic inflammatory disease and tubo-ovarian abscess are well-known complications. In males, complications such as epididymitis and prostatitis can occur.
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.
DRCOG MCQs for Circuit B Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Neisseria gonorrhoea:Gram-negative diplococcus bacterium.Infects the baby during childbirth.Causes ophthalmia neonatorum.Causes urethritis.Can cause perihepatitis.
A profile of the FDA-approved and CE/IVD-marked Aptima Mycoplasma genitalium assay (Hologic) and key priorities in the management of M. genitalium infections
Published in Expert Review of Molecular Diagnostics, 2020
Elena Shipitsyna, Magnus Unemo
Treatment of MG infections remains in most countries based on syndromic management for urethritis, cervicitis, and PID. However, resistance in MG to therapeutic antimicrobials, including the first-line macrolide azithromycin, has rapidly increased during the last 1–2 decades internationally, which often results in failure to eradicate the infection [2,8,11–13]. The resistance to azithromycin is primarily caused by mutations at nucleotide position A2058 or A2059 (Escherichia coli numbering) in the 23S rRNA gene [14]. Resistance to the second-line fluoroquinolone moxifloxacin [2,8] has also emerged, and its prevalence has been shown higher in WHO Western Pacific countries such as Japan, China, and Australia [13]. Moxifloxacin resistance is associated with mutations in the quinolone resistance-determining region (QRDR) of the parC gene, primarily mutations in amino acid codons S83 and D87 (MG numbering), whereas mutations in gyrA play a minor role but appear to affect the susceptibility at least together with some concomitant parC mutations [15–17]. Accordingly, accurate detection of MG, including testing for macrolide resistance-associated mutations in all MG-positive samples, is necessary for proper management of MG infections [2,8].
5-aminolevulinic acid photodynamic therapy for condyloma acuminatum of urethral meatus
Published in Journal of Dermatological Treatment, 2019
Jiajia Xie, Chunping Ao, Junpeng Li, Lifen Jiang, Hui Liu, Kang Zeng
As a sexually transmitted disease, genital warts are widely spread throughout the world. It can lead to the mucocutaneous intraepithelial neoplasia, which often occurs in the genital mucosa. The urethra is a hidden, warm and humid site for the HPV hiding and replicating at the same time. So the urethral genital warts tend to relapse. Up to now, there has been no large-scale epidemiological investigation about the incidence rate of urethral condyloma acuminatum. A report about 123 patients with urethral genital warts show that the incidence is 12.5% (9). Another research examined HPV-DNA of 463 healthy men reports that the urine samples were the poorest to detect with a rate of 10.1% among other genital sites (10). However, urethral condylomas are often combined with penile or vulva warts as well as urethritis, gonorrhea or other sexually transmitted infections. They mostly occur in people between 20 and 40 years old with high-risk behaviors. Patients complain of stinging, urethrorrhagia or dysuria when voiding (9). Some of them can find visible lesions in the distal urethra, such as the urethral meatus and navicular fossa places. But some others are not aware of suffering urethral meatus lesions (9). However, this does not rule out the possibility of genital warts. One of the reasons may be a latent infection, the other lies in that the warts can present in the upper urethra.
Conception and development of Urinary Tract Infection indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project
Published in The Journal of Spinal Cord Medicine, 2019
B. Catharine Craven, S. Mohammad Alavinia, Jerzy B. Gajewski, Raj Parmar, Sandi Disher, Karen Ethans, John Shepherd, Maryam Omidvar, Farnoosh Farahani, Magdy Hassouna, Blayne Welk
There is significant controversy in the field as to what constitutes a UTI. Although there is consensus that the term “UTI” refers to significant bacteriuria among individuals with SCI/D and NLUTD, with symptoms or signs of infection. For example, most clinicians agree fever is a symptom of UTI,12 although health care providers use a variety of less established symptoms and signs to diagnose UTI, many of which have low sensitivity and specificity for UTI diagnosis.13 Previously, thought leaders in the field have proposed that UTI is an umbrella term which represents a “heterogeneous group of clinical diagnoses” that encompasses several clinical entities including urethritis, vaginitis, interstitial cystitis, pyelonephritis, etc. Further, catheter-associated UTI rates vary by the infection definition and the method of bladder drainage.14 To further conflate the lack of clinical clarity regarding UTI diagnosis, many studies report different colony count criteria for defining bacteriuria, without distinguishing symptomatic from asymptomatic patients.15 In response to the terminology conundrums, the European Association of Urology (2017) has developed and disseminated several UTI definitions for uncomplicated UTIs, complicated UTIs, recurrent UTIs, catheter-associated UTIs, and urosepsis in their most recent Urological Infections Guidelines.9