urethritis in men Flashcards
possible causes of penile urethritis in men
chlamydia trachoma’s, mycoplasma genitalium and neisseria gonorrhoeae
herpes simplex virus, adenovirus and trichomonad vaginalis
normal urethral flora
ureaplasma, urealyticum
M genitalium is often resistant to
azithromycin or doxycycline
doxycycline is preferred
urethral discharge
gonorrhoea - usually copious and purulent
more common in men who have sex with men and aboriginal and Torres Strait islander people
dysuria
in a penis, this indicate an STI rather than a UTI until proven otherwise
urinary frequency
suggestive of bladder infection
FPU
first pass urine chlamydia trichromatic, mycoplasma genitlaium and neisseria gonorrhoeae
NAATs
a specific diagnosis can potentially reduce complications, re-infection and transmission
urethral swab
gonorrhoea culture and antibiotic sensitivity
in patients with urethral discharge
if test results are negative and symptoms persist,
consider test of FPU for herpes simples virus, adenovirus and trichomoniasis
for men who have sex with men
anorectal swabs and pharyngeal swabs for chlamydia (NAAT) and gonorrhoea (NAAT)
blood test for syphilis, HIV, hepatitis A and hep B.
consider testing for hep C if there is a history of injecting drug use or patient is HIV positive
NGU stands for
nongonoccocal urethritis
an injection of the urethra cause by some agent other than gonorrhoea
if the patient likely has an NGU
doxycycline 100mg PO, BD for 7 days
of gonorrhoea is likely
caftrioxone in lignocaine IMI stat
PLUS
azithromycin 1g PO stat
if mycoplasma genitalium is suspected
seek specialist advice
why is azithromycin added for treatment of gonorrhoea
ceftriaxone is the most effective treatment for gonorrhoea but azithromycin is added to reduce the chance of resistance emerging
