Urethritis


Epidemiology

Demographics

  • Peak Group: young, sexually active males
  • Relative Incidence: CDC estimates that there are 3x as many Chlamydia cases as Gonococcal cases in the US

Risk Factors for Sexually Transmitted Infections (STI)

  • Contact with Sex Workers
  • History of Sexually Transmitted Infection Within the Last 24 Months
  • Illicit Drug Use
  • Imprisonment
  • Meeting Partners on the Internet of Other Potentially Risky Partner Behaviors
  • Multiple Sex Partners
  • New Sex Partner in Last 3 Months
  • Residence in Urban Area
  • Unmarried Status
  • Young Age

Etiology

Infection

  • Adenovirus (see Adenovirus)
    • Risk Factor: insertive oral sex in males who have sex with males
  • Chlamydia Trachomatis (see Chlamydia Trachomatis)
    • Epidemiology: accounts for most cases of non-gonococcal urethritis
    • Incubation Period (Variable): 2-35 days
  • Cytomegalovirus (CMV) (see Cytomegalovirus)
  • Herpes Simplex Virus (HSV1 or HSV2) (see Herpes Simplex Virus)
    • Epidemiology: more commonly occurs in primary than in secondary infection
    • Risk Factor: insertive oral sex in males who have sex with males
  • Mycoplasma Genitalium (see Mycoplasma Genitalium)
  • Neisseria
    • Neisseria Gonorrhoeae (Gonococci) (see Neisseria Gonorrhoeae)
      • Appearance: Gram-negative coffee bean-shaped diplococci
      • Incubation Period: <2 wks
    • Neisseria Meningitidis (Meningococci) (see Neisseria Meningitidis)
      • Epidemiology: while uncommon as an etiology of urethritis, cases have increased in frequency since the 1970’s
  • Trichomonas Vaginalis (see Trichomonas Vaginalis)
  • Ureaplasma Urealyticum (see Ureaplasma Urealyticum)
  • Uropathogenic Escherichia Coli (UPEC) (see Escherichia Coli)
    • Risk Factor: insertive anal sex

Other


Diagnosis

Nucleic Acid Amplification Testing (NAAT) for Neisseria Gonorrhoeae and Chlamydia Trachomatis

Urinalysis with Urine Culture (see Urinalysis, [[Urinalysis]] and Urine Culture)

Urethral Swab with Culture

Other Testing


Screening

Recommended Screening for Sexually Transmitted Infections (STI) by Group (2010: CDC, IDSA, USPTF)

Screening Interval


Clinical Manifestations

Renal/Urologic Manifestations

Complications


Treatment

Antibiotics

General Comments

Infectious Diseases Society of America (IDSA) Guideline Recommended Regimens (see [MEDLINE])

Expedited Partner Therapy (EPT)

Sexually Transmitted Infections Required to Be Reported to California Public Health Department


References