Lecture notes for medical students

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6. Good for self study also.
7. See notes for bibliography.

2. Introduction & History.

3. Introduction & History.
• Urethritis is defined as infection-induced
inflammation of the urethra.
• The term is typically reserved to describe
urethral inflammation caused by an STD
and the condition is normally categorized
into either gonococcal urethritis (GU) or
nongonococcal urethritis (NGU).

4. Etiology

5. Etiology
• Gonococcal urethritis (GU)
• Nongonococcal urethritis (NGU).

6. Clinical Features

7. Clinical Features
• Asymptomatic .
• Urethral discharge: May be yellow, green,
brown, or tinged with blood
• Dysuria (in men)
• Typically not present are urinary frequency
and urgency, fever, chills, sweats, nausea
• Itching:
• Orchalgia: Heaviness in the male genitals

8. Investigations

9. Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histlogy

10. Investigations
• Urethral smear that demonstrates at least 5
leukocytes per oil immersion field on
microscopy
• First-voided urine specimen that
demonstrates leukocyte esterase on dipstick
test or at least 10 WBCs/hpf on microscopy
• Gram stain
• Endourethral and/or endocervical culture
for N gonorrhoeae andC trachomatis

11. Investigations
• STD testing for syphilis serology (VDRL)
and HIV serology
• Nasopharyngeal and/or rectal swabs: For
gonorrhea screening in men who have sex
with men

12. Differential Diagnosis

13. Differential Diagnosis
• Acute Bacterial Prostatitis and Prostatic
Abscess
• Herpes Simplex
• Human Papillomavirus
• Pelvic Inflammatory Disease
• Syphilis
• Urethral Strictures in Males
• Urethral Trauma
• Vulvovaginitis

14. Management

15. Management
• Azithromycin
• Ceftriaxone
• Cefixime
• Ciprofloxacin
• Ofloxacin
• Doxycycline
• Moxifloxacin

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