Inflammation of the urethra
Common manifestation of sexually transmitted infection (STI)
Frequently associated with dysuria, pruritus, and/or urethral discharge; classified as gonococc...
Chief complaint
Urethral discharge (mucopurulent suggestive of N. gonorrhoeae)
Dysuria
Erythema of the urethral meatus
Symptom onset 2 to 8 days following exposure
History
Sexual history, includin...
Most cases can be treated in the outpatient setting.
Single-dose regimens with direct observation preferred
Chlamydia
First line
Doxycycline 100 mg PO BID for 7 day...
Sexual activity should be avoided for 7 days following administration of single-dose therapy or until completion of multiday regimen.
All sexual partners who came ...
Chlamydia Infection (Sexually Transmitted); Epididymitis; Gonococcal Infections; Pelvic Inflammatory Disease; Prostatitis; Urinary Tract Infection (UTI) in Females; Urinary Tract Infection (U...
N34.2 Other urethritis
A56.01 Chlamydial cystitis and urethritis
A54.01 Gonococcal cystitis and urethritis, unspecified
N34.1 Nonspecific urethritis
M02.30 Reiter’s disease, unspecified site
Inflammation of the urethra, frequently associated with dysuria, pruritus, and/or urethral discharge
NAAT preferred method of diagnosis for men and women
In cases of gonorrhea or chlamyd...
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Pathogenesis of gonococcal infections. Neisseria gonorrhoea is a gram-negative diplococcus whose surface pili form a barrier against phagocytosis by neutrophils. The pili contain an IgA protease that digests IgA on the luminal surface of the mucous membranes of the urethra, endocervix, and fallopian tube, thereby facilitating attachment of gonococci. Gonococci cause endocervicitis, vaginitis, and salpingitis. In men, gonococci attached to the mucous membrane of the urethra cause urethritis ...
Pathogenesis of gonococcal infections. Neisseria gonorrhoea is a gram-negative diplococcus whose surface pili form a barrier against phago...
<bold>FIGURE 63-2</bold> <bold>Pathogenesis of urinary tract infections. A.</bold> Male urinary tract. <bold>B.</bold> Female urinary tract.
<bold>FIGURE 63-2</bold> <bold>Pathogenesis of urinary tract infections. A.</bold> Male urinary tract. <bold...
<bold>FIG. 125.1.</bold> Skin lesions characteristic of septicemia due to <italic>Neisseria gonorrhoeae</bold>. A: Hemorrhagic spot 5 to 6 mm in diameter on the upper arm; the gray area 1 to 2 mm in diameter in the center indicates necrosis. B: Pustulovesicular lesion on the finger of the same patient; the necrotic center is evident as a gray area.
<bold>FIG. 125.1.</bold> Skin lesions characteristic of septicemia due to <italic>Neisseria gonorrhoeae</bold>. A:...
FIG. 11.50. Disseminated gonococcemia. Neisseria gonorrhoeae may disseminate from mucosal surfaces via the bloodstream and produce arthritis/arthralgia and a rash. The most characteristic lesion is the hemorrhagic vesicopustule seen in the web space of the teenage girl's hand. There is a pustule on the sole of her foot.
FIG. 11.50. Disseminated gonococcemia. Neisseria gonorrhoeae may disseminate from mucosal surfaces via the bloodstream and produce arthrit...
Disseminated gonorrhea: pustule with hemorrhagic base and necrotic center.
Laparoscopic view of acute pelvic inflammatory disease (PID).
Pyosalpinx and blunted fimbria associated with acute PID.
Fig. 17-10 Urethral discharge associated with gonorrhea. This discharge may vary in color and copiousness and is accompanied by burning during urination.
Fig. 17-10 Urethral discharge associated with gonorrhea. This discharge may vary in color and copiousness and is accompanied by burning du...
Chlamydial mucopurulent cervicitis.
FIG. 9.16. A: Trichomonad in the vaginal discharge of a 17-year-old patient with gonococcal pelvic inflammatory disease. The flagellated protozoan is elliptical and somewhat larger than the adjacent polymorphonuclear leukocytes (2253 magnification). B: After suspension in saline solution for microscopy, trichomonads gradually become swollen and immobile. This balloon-shaped trichomonad is barely recognizable (2253 magnification).
FIG. 9.16. A: Trichomonad in the vaginal discharge of a 17-year-old patient with gonococcal pelvic inflammatory disease. The flagellated pr...