nongonococcal urethritis

1. nongonococcal urethritis

2. 1、Definition • nongonococcal urethritis（NGU）is a urethritis transmitted by copulation with the evident symptom of urethritis，while neisseria gonorrhoeae is not found in the urethral secretions. • Female patients have symptom of inflammation of genital tract such as urethra,cervix and so on,also known as “non-specificity gential tract infection”.

3. 2、etiology • The most frequent pathogen of NGU is chlamydia trachomatis • The next is mycoplasma • Trichomonas vaginalis • Blastomyces albicans • Herpes simplex virus

4. I: chlamydia chlamydia is a kind of prokaryotic microorganism that parasitize strickly in cells with a special developmental cycle and can pass through the bacterial filter.

5. Three biovarieties of chlamydia: • trachomatis:trachoma biovariety, venereal lymphogranuloma biovariety（LGV）and mouse biovariety. • trachoma biovariety can be devided into 12 serotypes from A to K, A、B、Ba、C 4 serotypes cause trachoma，D～K 8 serotypes cause infection of genitourinary system. • LGV can be devided into 3 serotypes :L1,L2 and L3 that cause venereal lymphogranuloma.

6. II:Mycoplasma Mycoplasma is a kind of prokaryotic and pleomorphic microorganisms belonged to class of soft bark that have no cell wall and precursor ,and can pass through the bacterial filter.

7. 3、transmission and epidemic way of infection： the main path of contact infection is the copulation,infrequently by non-sexual contact. epidemic： NGUis the most common sexually-transmitteddiseases in Euro-American with the highest incidence. NGU has increased continuously in our country recent years , in some regions the incidence have exceeded that of gonorrhea and been the highest one.

8. 4、clinical manifestation

9. I:male NGU • The incubation period is 1 to 3 weeks. • Itching of urethra with mild or severe urgency, odynuria and dysuria, the degree is milder than that of gonorrhea. • small amounts of dilute and mucous discharges are overflowed from urethral orifice when the patients don’t pass urine for a long time or at the morning,and the pasty discharges can clog the urethral orifice ,which is called “paste mouth” • Flare of urethral orifice that is not as evident as gonorrhea. • Some patients without any symptom

11. II:female NGU • mucopurulent cervicitis :more leukorrhea，edema or erosion of cervix，but the clinical symptom is not evident or with mild itching of vagina and pruritus vulvae. • urethritis:about 50% patients with urinary frequency and dysuria have no symptom of odynuria or mild odynuria,and small amounts of discharges are overflowed from urethral orifice when it is crushed.Many patients are without any symptom.

12. 5、diagnosis and differential diagnosis In addition to the symptom and signs,what the diagnosis required are as follows: Sexual contact outside of the marriage or mate with a history of infection Positivesmear of urethral secretions :> 4 polymorphonuclear leukocytes /1000 times high-power field of immersion objective Diagnostic signifcance of urina sanguinis(15ml ante-stream urinary sediment): > 15 polymorphonuclear leukocytes /400 times high-power field. Inspect pathogen when it is conditioned

13. 6、treatment • erythromycins： • Erythromycin 0.5 qid×7~14d(also for pregnant women) • Roxithromycin 0.15g Bid ×7 d • Azithromycin 1g taken once as a single dose • tetracyclines： • Tetracycline 0.5 qid×7d • Deoxycycline 100mg Bid ×7 d • Minocycline 100mg Bid ×10d • Norfloxacin 0.2 Bid×7~14d

14. 7 、criterion of cure • follow-up visit for 1 week after treatment is completed, criterion of cure: • Elimination of symptom • Smear of urethral secretions: ≤4 polymorphonuclear leukocytes /field of immersion objective • Negative pathogen inspection