Urethral discharge and dysuria Flashcards
How is urethritis diagnosed?
Discharge, dysuria
Urine - threads - pus cells with mucus
Microscopy - polymorphs in urethral discharge
What are the main causes of urethritis?
Chlamydia
Gonorrhoea
Mycoplasma
What are clinical features of chlamydia?
No symptoms, dysuria, discharge (both male and female)
What are complications of chlamydia?
Endometritis
Salpingitis
PID
Infertility (rare)
Ectopic pregnancy
Fitz-Hugh Curtis syndrome
Reiters syndrome
Epididymo-orchitis
What is chlamydia pneumonitis?
Chlamydial infection to baby due to vertical transmission
Staccato cough
Failure to thrive
Tachypnoea
What is vertical transmission of chlamydia associated with?
Pre-term birth
Preterm prolonged rupture of membranes
Low birth weight
How is chlamydia diagnosed?
1st void urine
Self taken vulvovaginal swab in women
Cervical/rectal/urethral swabs
Then, NAAT
What is treatment for chlamydia?
- Doxycycline - 100mg BD for 7 days
- Azithromycin 1mg STAT then 500mg OD for 2 days
- Erythromycin in pregnancy
Test of cure 4-6 weeks
What is NSU?
Non gonococcal non chlamydial urethritis
What is treatment of NSU?
Doxycycline - 100mg BD for 7 days then extended azithromycin 1mg STAT then 500mg OD for 2 days
What are symptoms of gonorrhoea?
Purulent discharge, dysuria
What are other sites of infection of gonorrhoea?
Rectum - purulent rectal discharge
Pharynx - pharyngitis
What are complications of gonorrhoea?
PID
Fetal loss
Conjunctivitis
Bartholin’s abscess
Epidiymo-orchitis
Appendicitis
What are symptoms of disseminated gonococcal infection?
Fever
Rash
Arthritis
Tendonitis
Septicaemia
How is gonorrhoea diagnosed?
Microscopy
NAAT test
Culture
