Transcript nongonococcal urethritis.ppt

nongonococcal
urethritis
1、Definition
•nongonococcal urethritis（NGU）is a
urethritis transmitted by copulation with the
evident symptom of urethritis，while neisseria
gonorrhoeae is not found in the urethral
secretions.
•Female patients have symptom of
inflammation of genital tract such as
urethra,cervix and so on,also known as “non-
specificity gential tract infection”.
2、etiology
•The most frequent pathogen of NGU
is chlamydia trachomatis
•The next is mycoplasma
•Trichomonas vaginalis
•Blastomyces albicans
•Herpes simplex virus
I: chlamydia
chlamydia
is
a
kind
of
prokaryotic
microorganism that parasitize strickly in cells
with a special developmental cycle and can
pass through the bacterial filter.
•Three biovarieties of chlamydia:
• trachomatis:trachoma biovariety, venereal
lymphogranuloma biovariety （ LGV ） and
mouse biovariety.
•trachoma biovariety can be devided into 12
serotypes from A to K, A 、 B 、 Ba 、 C 4
serotypes cause trachoma，D～K 8 serotypes
cause infection of genitourinary system.
•LGV can be devided into 3 serotypes :L1,L2
and L3 that cause venereal lymphogranuloma.
II:Mycoplasma
Mycoplasma is a kind of prokaryotic
and pleomorphic microorganisms belonged to
class of soft bark that have no cell wall and
precursor ,and can pass through the bacterial
filter.
3、transmission and epidemic
way of infection ： the main path of contact infection is
the copulation,infrequently by non-sexual contact.
epidemic ：
NGU is the most common sexually-
transmitted diseases in Euro-American with the highest
incidence.
NGU has increased continuously in our country recent
years , in some regions the incidence have exceeded that
of gonorrhea and been the highest one.
4、clinical manifestation
I:male NGU
The incubation period is 1 to 3 weeks.
•Itching of urethra with mild or severe urgency,
odynuria and dysuria, the degree is milder than that of
gonorrhea.
•small amounts of dilute and mucous discharges are
overflowed from urethral orifice when the patients
don’t pass urine for a long time or at the morning,and
the pasty discharges can clog the urethral orifice ,which
is called “paste mouth”
•Flare of urethral orifice that is not as evident as
gonorrhea.
•Some patients without any symptom
II:female NGU
•mucopurulent cervicitis :more leukorrhea，edema
or erosion of cervix，but the clinical symptom is not
evident or with mild itching of vagina and pruritus
vulvae.
•urethritis:about 50% patients with urinary frequency
and dysuria have no symptom of odynuria or mild
odynuria,and small amounts of discharges are
overflowed from urethral orifice when it is
crushed.Many patients are without any symptom.
5、diagnosis and differential diagnosis
In addition to the symptom and signs,what the
diagnosis required are as follows:
Sexual contact outside of the marriage or mate with
a history of infection
Positive smear of urethral secretions :> 4
polymorphonuclear leukocytes /1000 times highpower field of immersion objective
Diagnostic signifcance of urina sanguinis(15ml antestream urinary sediment): > 15 polymorphonuclear
leukocytes /400 times high-power field.
Inspect pathogen when it is conditioned
6、treatment
erythromycins：
•Erythromycin 0.5 qid×7~14d(also for pregnant women)
•Roxithromycin 0.15g Bid ×7 d
•Azithromycin 1g taken once as a single dose
tetracyclines：
•Tetracycline 0.5 qid×7d
•Deoxycycline 100mg Bid ×7 d
•Minocycline 100mg Bid ×10d
Norfloxacin 0.2 Bid×7~14d
7 、criterion of cure
follow-up visit for 1 week after treatment is
completed, criterion of cure:
•Elimination of symptom
•Smear of urethral secretions: ≤4
polymorphonuclear leukocytes /field of
immersion objective
•Negative pathogen inspection