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Matthew R Golden - One of the best experts on this subject based on the ideXlab platform.
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primary syphilis in the male urethra a case report
Clinical Infectious Diseases, 2019Co-Authors: Laura C Chambers, Matthew R Golden, Sheila A. Lukehart, Sujatha Srinivasan, Negusse Ocbamichael, Jennifer Morgan, Sylvan M Lowens, David N FredricksAbstract:: We documented urethral Treponema pallidum infection in a man with nongonococcal urethritis and a negative syphilis serology using broad-range bacterial polymerase chain reaction (PCR) and sequencing, targeted PCR, and immunofluorescence microscopy. He subsequently seroconverted for syphilis. Early syphilis may present as urethritis. Urethral T. pallidum shedding can occur before seroconversion.
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an estimate of the proportion of symptomatic gonococcal chlamydial and non gonococcal non chlamydial urethritis attributable to oral sex among men who have sex with men a case control study
Sexually Transmitted Infections, 2016Co-Authors: Lindley A. Barbee, Julia C Dombrowski, Christine M Khosropour, Lisa E. Manhart, Matthew R GoldenAbstract:Background Sexually transmitted infections (STIs) of the pharynx are common among men who have sex with men (MSM); the degree to which these infections are transmitted through oral sex is unknown. Methods We conducted a case–control study of MSM attending Public Health—Seattle & King County STD Clinic between 2001 and 2013 to estimate the proportion of symptomatic urethritis cases attributable to oral sex using two methods. First, we categorised men into the following mutually exclusive behavioural categories based on their self-reported sexual history in the previous 60 days: (1) only received oral sex (IOS); (2) 100% condom usage with insertive anal sex plus oral sex (PIAI); (3) inconsistent condom usage with anal sex (UIAI); and (4) no sex. We then determined the proportion of cases in which men reported the oropharynx as their only urethral exposure (IOS and PIAI). Second, we calculated the population attributable risk per cent (PAR%) associated with oral sex using Mantel–Haenszel OR estimates. Results Based on our behavioural categorisation method, men reported the oropharynx as their only urethral exposure in the past 60 days in 27.5% of gonococcal urethritis, 31.4% of chlamydial urethritis and 35.9% non-gonococcal, non-chlamydial urethritis (NGNCU) cases. The PAR%s for symptomatic gonococcal urethritis, chlamydial urethritis and NGNCU attributed to oropharyngeal exposure were 33.8%, 2.7% and 27.1%, respectively. Conclusions The pharynx is an important source of gonococcal transmission, and may be important in the transmission of chlamydia and other, unidentified pathogens that cause urethritis. Efforts to increase pharyngeal gonorrhoea screening among MSM could diminish STI transmission.
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an estimate of the proportion of symptomatic gonococcal chlamydial and non gonococcal non chlamydial urethritis attributable to oral sex among men who have sex with men a case control study
Sexually Transmitted Infections, 2016Co-Authors: Lindley A. Barbee, Julia C Dombrowski, Christine M Khosropour, Lisa E. Manhart, Matthew R GoldenAbstract:Background Sexually transmitted infections (STIs) of the pharynx are common among men who have sex with men (MSM); the degree to which these infections are transmitted through oral sex is unknown. Methods We conducted a case–control study of MSM attending Public Health—Seattle & King County STD Clinic between 2001 and 2013 to estimate the proportion of symptomatic urethritis cases attributable to oral sex using two methods. First, we categorised men into the following mutually exclusive behavioural categories based on their self-reported sexual history in the previous 60 days: (1) only received oral sex (IOS); (2) 100% condom usage with insertive anal sex plus oral sex (PIAI); (3) inconsistent condom usage with anal sex (UIAI); and (4) no sex. We then determined the proportion of cases in which men reported the oropharynx as their only urethral exposure (IOS and PIAI). Second, we calculated the population attributable risk per cent (PAR%) associated with oral sex using Mantel–Haenszel OR estimates. Results Based on our behavioural categorisation method, men reported the oropharynx as their only urethral exposure in the past 60 days in 27.5% of gonococcal urethritis, 31.4% of chlamydial urethritis and 35.9% non-gonococcal, non-chlamydial urethritis (NGNCU) cases. The PAR%s for symptomatic gonococcal urethritis, chlamydial urethritis and NGNCU attributed to oropharyngeal exposure were 33.8%, 2.7% and 27.1%, respectively. Conclusions The pharynx is an important source of gonococcal transmission, and may be important in the transmission of chlamydia and other, unidentified pathogens that cause urethritis. Efforts to increase pharyngeal gonorrhoea screening among MSM could diminish STI transmission.
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p3 162 an estimate of the proportion of gonococcal chlamydial and non gonococcal non chlamydial urethritis ngncu attributable to oral sex among men who have sex with men msm
Sexually Transmitted Infections, 2013Co-Authors: Lindley A. Barbee, Julia C Dombrowski, Lisa E. Manhart, Matthew R GoldenAbstract:Background The proportion of infectious urethritis associated with oral sex is unknown. Methods We conducted a retrospective study of MSM diagnosed with symptomatic urethritis attending an STD Clinic between 2001–2010. We categorised men according to their urethral exposures in the previous 60 days: (1) only insertive oral sex and no insertive anal sex (IOS); (2) only protected insertive anal intercourse and insertive oral sex (PIAI); (3) unprotected insertive anal intercourse with or without oral sex (UIAI); (4) no insertive sex (oral or anal). We calculated the proportion of urethritis cases by groups as a minimum estimate of the proportion of cases attributable to oral sex. Results Between 2001–2010, 4,091 MSM were diagnosed with urethritis, had complete records for categorization, and were included in this analysis. Men reported the following urethral exposures: 13% IOS, 21% PIAI, 65% UIAI, and Conclusion While usually considered a safer sexual practise, our findings suggest that a large proportion of all cases of urethritis are attributable to insertive oral sex. These findings highlight the importance of screening the oropharynx and counselling MSM about the risks of oral sex.
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asymptomatic urethritis is common and is associated with characteristics that suggest sexually transmitted etiology
Sexually Transmitted Diseases, 2013Co-Authors: Catherine W Gillespie, Sylvan M Lowens, Lisa E. Manhart, Matthew R GoldenAbstract:We evaluated 236 asymptomatic men for urethritis, assessed sexual behaviors, and tested urine for pathogens. Asymptomatic urethritis was present in 38 (16.1%). Of these, nearly half (42.1%) had a previously unrecognized discharge on examination; only 18.4% had a known pathogen. Correlates included black race, anal intercourse, and number of sex partners.
Marcus Y Chen - One of the best experts on this subject based on the ideXlab platform.
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clinical characteristics of herpes simplex virus urethritis compared with chlamydial urethritis among men
Sexually Transmitted Diseases, 2017Co-Authors: Anna N Morton, Jane S Hocking, Helen Henzell, Karen Berzins, Julian Druce, Tim R H Read, Christopher K. Fairley, Catriona S. Bradshaw, Marcus Y ChenAbstract:BACKGROUND: The aim of this study was to ascertain the clinical characteristics associated with herpes simplex virus (HSV) urethritis in men and to compare those with chlamydial urethritis. METHODS: We compared clinical and laboratory data from men diagnosed with polymerase chain reaction confirmed HSV urethritis with those of men with chlamydial urethritis presenting to Melbourne Sexual Health Centre between 2000 and 2015. RESULTS: Eighty HSV urethritis cases were identified: 55 (68%, 95% confidence interval, 58-78) were by HSV-1 and 25 (32%, 95% confidence interval, 22-42) by HSV-2. Compared with chlamydial urethritis, men with HSV urethritis were significantly more likely to report severe dysuria (20% vs 0%, P < 0.01) or constitutional symptoms (15% vs 0%, P < 0.01). Men with HSV urethritis were significantly more likely to have meatitis (62% vs 23%, P < 0.01), genital ulceration (37% vs 0%, P < 0.01), or inguinal lymphadenopathy (30% vs 0%, P < 0.01) but less likely to have urethral discharge (32% vs 69%, P < 0.01). There was no significant difference in the proportion of men who had raised (≥5) polymorphonuclear leukocytes per high-powered field between the two groups (P = 0.46). CONCLUSIONS: The clinical presentation of HSV urethritis in men may differ from those of chlamydial urethritis and guide testing for HSV in men presenting with non-gonococcal urethritis.
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clinical characteristics of herpes simplex virus urethritis compared with chlamydial urethritis among men
Sexually Transmitted Diseases, 2017Co-Authors: Anna N Morton, Jane S Hocking, Helen Henzell, Karen Berzins, Julian Druce, Tim R H Read, Christopher K. Fairley, Catriona S. Bradshaw, Marcus Y ChenAbstract:BACKGROUND: The aim of this study was to ascertain the clinical characteristics associated with herpes simplex virus (HSV) urethritis in men and to compare those with chlamydial urethritis. METHODS: We compared clinical and laboratory data from men diagnosed with polymerase chain reaction confirmed HSV urethritis with those of men with chlamydial urethritis presenting to Melbourne Sexual Health Centre between 2000 and 2015. RESULTS: Eighty HSV urethritis cases were identified: 55 (68%, 95% confidence interval, 58-78) were by HSV-1 and 25 (32%, 95% confidence interval, 22-42) by HSV-2. Compared with chlamydial urethritis, men with HSV urethritis were significantly more likely to report severe dysuria (20% vs 0%, P < 0.01) or constitutional symptoms (15% vs 0%, P < 0.01). Men with HSV urethritis were significantly more likely to have meatitis (62% vs 23%, P < 0.01), genital ulceration (37% vs 0%, P < 0.01), or inguinal lymphadenopathy (30% vs 0%, P < 0.01) but less likely to have urethral discharge (32% vs 69%, P < 0.01). There was no significant difference in the proportion of men who had raised (≥5) polymorphonuclear leukocytes per high-powered field between the two groups (P = 0.46). CONCLUSIONS: The clinical presentation of HSV urethritis in men may differ from those of chlamydial urethritis and guide testing for HSV in men presenting with non-gonococcal urethritis.
Yonatan H Grad - One of the best experts on this subject based on the ideXlab platform.
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genomic characterization of urethritis associated neisseria meningitidis shows that a wide range of n meningitidis strains can cause urethritis
Journal of Clinical Microbiology, 2017Co-Authors: Kevin C, Makoto Ohnishi, Magnus Unemo, Samo Jeverica, Robert D Kirkcaldy, Yonatan H Grad, Hideyuki TakahashiAbstract:ABSTRACT Neisseria meningitidis, typically a resident of the oro- or nasopharynx and the causative agent of meningococcal meningitis and meningococcemia, is capable of invading and colonizing the urogenital tract. This can result in urethritis, akin to the syndrome caused by its sister species, N. gonorrhoeae, the etiologic agent of gonorrhea. Recently, meningococcal strains associated with outbreaks of urethritis were reported to share genetic characteristics with the gonococcus, raising the question of the extent to which these strains contain features that promote adaptation to the genitourinary niche, making them gonococcus-like and distinguishing them from other N. meningitidis strains. Here, we analyzed the genomes of 39 diverse N. meningitidis isolates associated with urethritis, collected independently over a decade and across three continents. In particular, we characterized the diversity of the nitrite reductase gene (aniA), the factor H-binding protein gene (fHbp), and the capsule biosynthetic locus, all of which are loci previously suggested to be associated with urogenital colonization. We observed notable diversity, including frameshift variants, in aniA and fHbp and the presence of intact, disrupted, and absent capsule biosynthetic genes, indicating that urogenital colonization and urethritis caused by N. meningitidis are possible across a range of meningococcal genotypes. Previously identified allelic patterns in urethritis-associated N. meningitidis strains may reflect genetic diversity in the underlying meningococcal population rather than novel adaptation to the urogenital tract.
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p1 59 genomic characterisation of urethritis associated neisseria meningitidis
Sexually Transmitted Infections, 2017Co-Authors: Kevin C, Makoto Ohnishi, Magnus Unemo, Samo Jeverica, Robert D Kirkcaldy, Yonatan H GradAbstract:Introduction Mainly case reports have shown that N. meningitidis , typically a resident of the oropharynx and the causative agent of meningococcal meningitis and meningococcemia, is capable of invading and colonising the urogenital tract. This can result in urethritis, akin to the syndrome caused by N. gonorrhoeae , the etiologic agent of gonorrhoea. Recently, meningococcal strains associated with outbreaks of urethritis were reported to share genetic characteristics with gonococcus, raising the question of the extent to which these strains contain features that promote adaptation to the genitourinary niche, making them “gonococcus-like” and distinguishing them from other N. meningitidis . Methods A total of 31 urethritis-associated N. meningitidis , representing multiple serogroups and independently collected over a decade and 3 continents, underwent genome sequencing and analysis. The genomes were compared with serogroup-matched N. meningitidis strains isolated from carriage and invasive disease and N. gonorrhoeae strains isolated from men with urethritis. Results Intact nitrite reductase (AniA), disrupted factor-H binding protein (fHbp), and the lack of capsule are features previously speculated to promote urogenital colonisation. However, we found that a considerable number (n=11) of meningococcal urethritis isolates harbour mutations in AniA predicted to result in truncated peptides and a minority (n=4) of these isolates contained alleles associated with frameshifted fHbp. We noted substantial diversity in the capsule biosynthetic locus, including intact, disrupted, and absent capsules, indicating urogenital colonisation is possible across a range of capsular phenotypes. Conclusion The meningococcal urethritis strains in this study do not share the allelic patterns of AniA, fHbp, or the capsule locus previously reported for urethritis-associated N. meningitidis . The allelic patterns likely reflect diversity in the underlying meningococcal population, rather than novel adaptation to the urogenital tract.
Takashi Deguchi - One of the best experts on this subject based on the ideXlab platform.
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Comparative study flow diagram.
2019Co-Authors: Nozomu Hanaoka, Mitsuru Yasuda, Shin Ito, Masami Konagaya, Naomi Nojiri, Tsuguto Fujimoto, Takashi DeguchiAbstract:A total of 650 clinical visitors were enrolled in this study. They were categorized into two groups. The acute urethritis group included 398 cases, and the no symptoms (asymptomatic) group included 163 individuals. FVU was used for all tests. All specimens underwent screening for the following microorganisms: NG, CT, MG, MH, UP, UU, HI, NM, SP, TV, HAdVs, and HSV. aThe 23 cases in which only HAdV DNA was detected were confirmed as adenoviral urethritis (AU) cases and bthe nine cases in which HAdV DNA and other pathogens were simultaneously detected were considered as adenovirus-associated urethritis (AAU) cases. A total of 32 cases were confirmed as urethritis with adenovirus in the acute urethritis group. Among the 163 individuals in the asymptomatic group, only one case was positive for HAdV DNA alone and two cases simultaneously had both HAdV DNA and other pathogens. Other pathogens were detected in 37 FVU samples, and 124 patients exhibited no pathogens in urine. Abbreviations: NG, Neisseria gonorrhoeae; CT, Chlamydia trachomatis; MG, Mycoplasma genitalium; MH, Mycoplasma hominis, UP, Ureaplasma parvum; UU, Ureaplasma urealyticum; HI, Haemophilus influenzae; NM, Neisseria meningitidis; SP, Streptococcus pneumoniae; TV, Trichomonas vaginalis; HAdV, Human adenovirus; HV, herpes simplex virus.
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antimicrobial susceptibility of haemophilus influenzae strains isolated from the urethra of men with acute urethritis and or epididymitis
Journal of Infection and Chemotherapy, 2017Co-Authors: Takashi Deguchi, Mitsuru Yasuda, Nozomu Hanaoka, Tomohiro Tsuchiya, Shigeaki Yokoi, Kyoko Hatazaki, Kengo Horie, Keita Nakane, Kosuke Mizutani, Ken ShimutaAbstract:Abstract We determined minimum inhibitory concentrations (MICs) of 41 antimicrobial agents for 73 clinical strains of Haemophilus influenzae isolated from the urethra of men with acute urethritis and/or epididymitis and examined the strains for the production of β-lactamase. We also compared their antimicrobial susceptibilities with those of H. influenzae strains from respiratory tract or otorhinolaryngological infections that were reported in Japan. The proportion of β-lactamase-nonproducing ampicillin-resistant strains from acute urethritis and/or epididymitis appeared to be lower, but that of β-lactamase-producing ampicillin-resistant strains appeared to be higher, compared with those from respiratory tract or otorhinolaryngological infections. However, their antimicrobial susceptibilities to a variety of other antimicrobial agents would be similar to those from respiratory tract or otorhinolaryngological infections. Almost all of the strains of H. influenzae from acute urethritis and/or epididymitis were susceptible to the agents, including ceftriaxone, quinolones, macrolides, and tetracyclines, commonly prescribed for treatment of acute urethritis based on the MIC breakpoints recommended by the Clinical and Laboratory Standards Institute. Ceftriaxone and quinolones could be effective on H. influenzae -induced urethritis. However, azithromycin treatment failures were reported in acute urethritis caused by H. influenzae strains considered susceptible to azithromycin. Further studies will be needed to determine MIC breakpoints of antimicrobial agents, which are recommended for treatment of urogenital infections, for H. influenzae strains causing these infections. Nevertheless, this study provides useful data regarding antimicrobial susceptibilities of H. influenzae strains isolated from the urogenital tract, which have rarely been studied.
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Male non-gonococcal urethritis: From microbiological etiologies to demographic and clinical features.
International Journal of Urology, 2016Co-Authors: Shin Ito, Mitsuru Yasuda, Nozomu Hanaoka, Ken Shimuta, Kensaku Seike, Tomohiro Tsuchiya, Shigeaki Yokoi, Masahiro Nakano, Makoto Ohnishi, Takashi DeguchiAbstract:Objectives To detect microorganisms responsible for male acute urethritis and to define the microbiology of non-gonococcal urethritis. Methods The present study comprised 424 men with symptoms and signs compatible with acute urethritis. Their urethral swabs and first-voided urine underwent detection of the microorganisms. Demographic characteristics and clinical features of Mycoplasma genitalium-, Ureaplasma urealyticum-, Haemophilus influenza-, adenovirus- or Herpes simplex virus-positive monomicrobial non-gonococcal urethritis, or all-examined microorganism-negative urethritis in heterosexual men were compared with urethritis positive only for Chlamydia trachomatis. Results Neisseria gonorrhoeae was detected in 127 men (30.0%). In 297 men with non-gonococcal urethritis, C. trachomatis was detected in 143 (48.1%). In 154 men with non-chlamydial non-gonococcal urethritis, M. genitalium (22.7%), M. hominis (5.8%), Ureaplasma parvum (9.1%), U. urealyticum (19.5%), H. influenzae (14.3%), Neisseria meningitidis (3.9%), Trichomonas vaginalis (1.3%), human adenovirus (16.2%), and Herpes simplex virus types 1 (7.1%) and 2 (2.6%) were detected. Although some features of monomicrobial non-chlamydial non-gonococcal urethritis or all-examined microorganism-negative urethritis were significantly different from those of monomicrobial chlamydial non-gonococcal urethritis, most features were superimposed. Conclusions Predicting causative microorganisms in men with non-gonococcal urethritis based on demographic and clinical features is difficult. However, the present study provides useful information to better understand the microbiological diversity in non-gonococcal urethritis, and to manage patients with non-gonococcal urethritis appropriately.
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mycoplasma genitalium another important pathogen of nongonococcal urethritis
The Journal of Urology, 2002Co-Authors: Takashi Deguchi, Shinichi MaedaAbstract:Purpose: We reviewed findings on the pathogenic role of Mycoplasma genitalium in nongonococcal urethritis and the treatment of men with M. genitalium positive nongonococcal urethritis.Materials and Methods: We reviewed literature selected from peer reviewed journals listed in MEDLINE and from resources cited in those articles from 1967 to January 2001.Results: M. genitalium was first isolated from 2 men with nongonococcal urethritis and thereafter it was shown to cause urethritis in subhuman primates inoculated intraurethrally. This mycoplasma has been detected significantly more often in patients with acute nongonococcal urethritis, particularly in those with nonchlamydial nongonococcal urethritis, than in those without urethritis. The prevalence of M. genitalium positive nonchlamydial nongonococcal urethritis is 18.4% to 45.5% of all nonchlamydial nongonococcal urethritis cases. In addition, the persistence of M. genitalium in the urethra after antimicrobial chemotherapy is associated with persistent or...
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diagnosis of gonococcal urethritis and chlamydial urethritis by polymerase chain reaction
The Japanese Journal of Urology, 1992Co-Authors: Takashi Deguchi, Hisao Komeda, Emiko Kanematsu, Yukimichi Kawada, Hisashi Iwata, A. Saito, K Tada, H. YamamotoAbstract:: A polymerase chain reaction (PCR) method was compared to standard methods (cultures for Neisseria gonorrhoeae and Chlamydia trachomatis and an enzyme-immunoassay for C. trachomatis) in diagnosis of gonococcal and chlamydial urethritis in 40 male patients with urethritis. Gonococcal urethritis was diagnosed by detection of a 206 bp DNA fragment amplified by PCR with N. gonorrhoeae-specific primers. Chlamydial urethritis was diagnosed by detection of a 242 bp DNA fragment amplified by PCR with C. trachomatis-specific primers. Gonococcal and chlamydial urethritis, gonococcal and non-chlamydial urethritis, non-gonococcal and chlamydial urethritis, and non-gonococcal and non-chlamydial urethritis were diagnosed in 8, 10, 14 and 8 patients, respectively, by the PCR method. In 9 patients with gonococcal and chlamydial urethritis, 10 with gonococcal and non-chlamydial urethritis, 12 with non-gonococcal and chlamydial urethritis, and 9 with non-gonococcal and non-chlamydial urethritis, diagnosed by the standard methods, the coincidence rates of the PCR to the standard methods were 78% (7/9), 90% (9/10), 100% (12/12), and 89% (8/9), respectively. The overall coincidence rate between the PCR and the standard methods in diagnosis of urethritis were high (90%). In addition, N.gonorrhoeae and C.trachomatis could be simultaneously detected from one urethral sample in approximately 6 hours by means of the PCR. Thus, the PCR method could clinically be applied and would offer several advantages to diagnosis of urethritis, compared to the standard methods.
Christopher K. Fairley - One of the best experts on this subject based on the ideXlab platform.
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clinical characteristics of herpes simplex virus urethritis compared with chlamydial urethritis among men
Sexually Transmitted Diseases, 2017Co-Authors: Anna N Morton, Jane S Hocking, Helen Henzell, Karen Berzins, Julian Druce, Tim R H Read, Christopher K. Fairley, Catriona S. Bradshaw, Marcus Y ChenAbstract:BACKGROUND: The aim of this study was to ascertain the clinical characteristics associated with herpes simplex virus (HSV) urethritis in men and to compare those with chlamydial urethritis. METHODS: We compared clinical and laboratory data from men diagnosed with polymerase chain reaction confirmed HSV urethritis with those of men with chlamydial urethritis presenting to Melbourne Sexual Health Centre between 2000 and 2015. RESULTS: Eighty HSV urethritis cases were identified: 55 (68%, 95% confidence interval, 58-78) were by HSV-1 and 25 (32%, 95% confidence interval, 22-42) by HSV-2. Compared with chlamydial urethritis, men with HSV urethritis were significantly more likely to report severe dysuria (20% vs 0%, P < 0.01) or constitutional symptoms (15% vs 0%, P < 0.01). Men with HSV urethritis were significantly more likely to have meatitis (62% vs 23%, P < 0.01), genital ulceration (37% vs 0%, P < 0.01), or inguinal lymphadenopathy (30% vs 0%, P < 0.01) but less likely to have urethral discharge (32% vs 69%, P < 0.01). There was no significant difference in the proportion of men who had raised (≥5) polymorphonuclear leukocytes per high-powered field between the two groups (P = 0.46). CONCLUSIONS: The clinical presentation of HSV urethritis in men may differ from those of chlamydial urethritis and guide testing for HSV in men presenting with non-gonococcal urethritis.
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clinical characteristics of herpes simplex virus urethritis compared with chlamydial urethritis among men
Sexually Transmitted Diseases, 2017Co-Authors: Anna N Morton, Jane S Hocking, Helen Henzell, Karen Berzins, Julian Druce, Tim R H Read, Christopher K. Fairley, Catriona S. Bradshaw, Marcus Y ChenAbstract:BACKGROUND: The aim of this study was to ascertain the clinical characteristics associated with herpes simplex virus (HSV) urethritis in men and to compare those with chlamydial urethritis. METHODS: We compared clinical and laboratory data from men diagnosed with polymerase chain reaction confirmed HSV urethritis with those of men with chlamydial urethritis presenting to Melbourne Sexual Health Centre between 2000 and 2015. RESULTS: Eighty HSV urethritis cases were identified: 55 (68%, 95% confidence interval, 58-78) were by HSV-1 and 25 (32%, 95% confidence interval, 22-42) by HSV-2. Compared with chlamydial urethritis, men with HSV urethritis were significantly more likely to report severe dysuria (20% vs 0%, P < 0.01) or constitutional symptoms (15% vs 0%, P < 0.01). Men with HSV urethritis were significantly more likely to have meatitis (62% vs 23%, P < 0.01), genital ulceration (37% vs 0%, P < 0.01), or inguinal lymphadenopathy (30% vs 0%, P < 0.01) but less likely to have urethral discharge (32% vs 69%, P < 0.01). There was no significant difference in the proportion of men who had raised (≥5) polymorphonuclear leukocytes per high-powered field between the two groups (P = 0.46). CONCLUSIONS: The clinical presentation of HSV urethritis in men may differ from those of chlamydial urethritis and guide testing for HSV in men presenting with non-gonococcal urethritis.
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azithromycin failure in mycoplasma genitalium urethritis
Emerging Infectious Diseases, 2006Co-Authors: Catriona S. Bradshaw, Tim R H Read, Jørgen Skov Jensen, Sepehr N Tabrizi, Suzanne M Garland, Carol A Hopkins, Lorna M Moss, Christopher K. FairleyAbstract:We report significant failure rates (28%, 95% confidence interval 15%–45%) after administering 1 g azithromycin to men with Mycoplasma genitalium–positive nongonococcal urethritis. In vitro evidence supported reduced susceptibility of M. genitalium to macrolides. Moxifloxacin administration resulted in rapid symptom resolution and eradication of infection in all cases. These findings have implications for management of urethritis.
