Urethritis [Men]

Valeria Fabre, M.D.
Urethritis [Men] is a topic covered in the Johns Hopkins ABX Guide.

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  • Commonly implicated:
    • Chlamydia trachomatis (CT) : most frequent cause of urethritis in men accounting for 23%-55% of cases. However, the proportion of non-gonococcal urethritis (NGU) cases due to CT is declining gradually.
    • Mycoplasma genitalium: may be the second most frequent cause of urethritis in the U.S and U.K. May account for between 15%-22% of cases of acute NGU. Also has a role in chronic NGU.
    • Neisseria gonorrhoeae: as a cause of urethritis, gonorrhea is increasingly a geographically isolated infection in the US. It persists in inner-city populations, in particular.
    • Trichomonas vaginalis: is the cause of only about 2% of cases of acute NGU but probably a higher proportion of chronic NGU.
    • Ureaplasma urealyticum: biovar 2 is probably a more important cause of acute NGU than previously realized. In 1999 the organism was divided into 2 species: U. parnumparnum (Biovar 1) and U. urealyticum (Biovar 2). Studies suggest only the latter associated with urethritis.
  • Less common: include
    • Herpes simplex virus (rare in absence of obvious skin lesions)
    • Adenovirus
    • Haemophilus spp
    • Yeasts, e.g., Candida spp.
    • N. meningitidis 
    • Staphylococcus saprophyticus.  
    • Novel bacteria recently associated with bacterial vaginosis such as Leptotrichia/Sneathia spp. may be the urethral pathogens of "idiopathic" NGU[7].

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Last updated: November 30, 2015