You are on page 1of 16

Mae Tao Clinic 1

Case Definition

 Discharge from the urethra of the male penis.


 May be accompanied by dysuria, but dysuria is
not always present.

2
Causative Agents

 Neisseria gonorrhea
 Chlamydia trachomatis
 Trichomonas
 Non-specific urethritis pathogens

3
Clinical Features of Gonococcal and Non-
Gonococcal Urethritis
Clinical Features Gonococcal Non-Gonococcal

Incubation Period Shorter Longer

Onset of Symptoms Abrupt Gradual

Clinical Discharge 70% 40%

Type of Discharge Purulent Mucoid

4
Mae Tao Clinic 5
Symptoms and Signs
 Discharge from the penis
 Burning or itching at the opening of the penis
 Burning on urination
 Swollen or painful testicles

6
Symptoms and Signs
 Only 10% of men have symptoms of gonorrhea.
 Only 50% of men have symptoms of chlamydia.
 Symptoms usually occur 2 to 7 days after
gonorrhea infection. 3 weeks for chlamydia.

7
Gonorrhea - gram stain of
urethral discharge

Mae Tao Clinic 8


Gonococcal urethritis

Mae Tao Clinic 9


Physical Examination
 Examination of Urethral Discharge,
 If none is seen, massage the ventral part of
Penis.
 Microscopy >5 neutrophil/HPF Urethritis.

10
Gonorrhea

11
Nongonococcal Urethritis

Mae Tao Clinic 12


Treatrment
 For Gonorrhoeae –
- Ciprofloxacin 500mg PO Single dose, or
- Azithromycin 2g PO Single dose.

 For Chlamydiasis –
- Doxycycline 100mg PO BID *7 days, or
- Azithromycin 1g PO Single dose.

 For Trichomoniasis –
- Metronidazole 2g PO Single dose, or
- Tinidazole 2g PO Single dose.

13
Treatment
 Ciprofloxin 500 mg PO  Doxycycline 100 mg PO
stat BID x 14 days

14
Persistent Urethral Discharge

 Drug resistance,
 Poor Compliance,
 Re-infection,
 Infection with T. vaginalis.

15
Thank You.

16

You might also like