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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.
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
Non-gonococcal urethritis: caused by Chlamydia trachomatis and other organisms such as Mycoplasma genitalium and Ureaplasma urealyticum. Treatment: recommended regimens are single dose azithromycin or seven days of doxycycline.
We have the technology, but should we build the test?
Published in Expert Review of Molecular Diagnostics, 2018
Finally, the example of Mycoplasma genitalium (MG) provides yet one more example of the ability of technology to outpace our understanding of clinical utility. MG was first isolated from men with urethritis in the United Kingdom in the early 1980’s. We now know that this organism is likely transmitted between sexual partners and is strongly associated with discharge syndromes such as urethritis and cervicitis. In some populations, mycoplasma is more often identified in men with non-gonococcal urethritis than with chlamydia. However, this organism is extremely difficult to detect using culture and we now rely on molecular diagnostic tools [11]. Several assays are commercially available worldwide and are often used to screen for infections in asymptomatic patients. This is not consistent with the recommendations for diagnosis of mycoplasma, but the testing is often bundled with chlamydia/gonorrhea screening which is performed in asymptomatic populations. Thus, despite recommendations, the availability of molecular tools may be encouraging screening that could ultimately lead to selection pressure and drive continued increases in antimicrobial-resistant M. genitalium.
Antimicrobial susceptibility of Mycoplasma genitalium isolates from Pretoria, South Africa in 2012 and 2016
Published in Southern African Journal of Infectious Diseases, 2018
Marie C Le Roux, Maanda Mafunise, Barbara E de Villiers, Ramalau Mm Ditsele
Like all mycoplasmas, M. genitalium has natural resistance against all beta-lactam agents and other antibiotics targeting peptidoglycan assembly since they lack a cell wall. Treatment options are tetracyclines, macrolides, and fluoroquinolones. Although doxycycline has been used to treat nongonococcal urethritis and cervicitis for many years, it has been shown to have poor efficacy against M. genitalium and isolates with reduced susceptibility have been reported.5 The macrolide azithromycin is now preferred for the treatment of nongonococcal urethritis and related clinical syndromes. However, after the first report in 2006 of azithromycin resistance observed in M. genitalium isolates among Australian patients,20 the efficacy of the drug in treating M. genitalium infections has decreased worldwide.21
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.