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Non-gonococcal urethritis
Non-gonococcal urethritis
Non-gonococcal urethritis (NGU, sometimes referred to as non-specific urethritis) is a term used to describe the presence of urethritis when a gonococcal bacteria are not identifiable or the initial swab. A typical case would be a male who presented to a GUM clinic with a purulent urethral discharge and dysuria. A swab would be taken in clinic, microscopy performed which showed neutrophils but no Gram-negative diplococci (i.e. no evidence of gonorrhoea). Clearly, this patient requires immediate treatment prior to waiting for the Chlamydia test to come back and hence an initial diagnosis of NGU is made.No cause is found in around half of cases. Possible causative organisms include:
- Chlamydia trachomatis
- most common cause
- Mycoplasma genitalium
- thought to cause more symptoms than Chlamydia
- less common causes
- Ureaplasma urealyticum
- Trichomonas vaginalis
- Escherichia coli
Management
- contact tracing
- the BNF and British Association for Sexual Health and HIV (BASHH) both recommend either oral azithromycin or doxycycline
+PassMedicine Notes
Non-gonococcal urethritis (NGU, sometimes referred to as non-specific urethritis) is a term used to describe the presence of urethritis when a gonococcal bacteria are not identifiable or the initial swab. A typical case would be a male who presented to a GUM clinic with a purulent urethral discharge and dysuria. A swab would be taken in clinic, microscopy performed which showed neutrophils but no Gram-negative diplococci (i.e. no evidence of gonorrhoea). Clearly, this patient requires immediate treatment prior to waiting for the Chlamydia test to come back and hence an initial diagnosis of NGU is made.
No cause is found in around half of cases. Possible causative organisms include:- Chlamydia trachomatis
- most common cause
- Mycoplasma genitalium
- thought to cause more symptoms than Chlamydia
- less common causes
- Ureaplasma urealyticum
- Trichomonas vaginalis
- Escherichia coli
- contact tracing
- the BNF and British Association for Sexual Health and HIV (BASHH) both recommend either oral azithromycin or doxycycline