Urethritis [Men]
Urethritis [Men] is a topic covered in the Johns Hopkins ABX Guide.
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PATHOGENS
- Gonococcal urethritis:5-20%
- Neisseria gonorrhoeae: 5-20% of urethritis in the U.S. (higher in inner-city populations).
- Non-gonococcal urethritis:
- Chlamydia trachomatis (CT): the 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: maybe the second most frequent cause of urethritis in the U.S. and UK. It May account for between 15%-22% of cases of acute NGU. It also has a role in chronic NGU.
- Trichomonas vaginalis: is the cause of only about 2% of cases of acute NGU but probably a higher proportion of chronic NGU.
- Risks in men for infertility, HIV.
- Ureaplasma urealyticum: biovar 2 is probably a more important cause of acute NGU than previously realized. Note that organisms can be cultured in 30-40% of asymptomatic men. Quantification of the organism may help establish a diagnosis.
- Less common: include
- Herpes simplex virus (rare in the absence of noticeable skin lesions)
- Adenovirus
- Haemophilus spp
- Yeasts, e.g., Candida spp.
- N. meningitidis
- Increasingly described in symptomatic MSM.
- Staphylococcus saprophyticus.
- Novel bacteria recently associated with bacterial vaginosis, such as Leptotrichia/Sneathia spp. may be the urethral pathogens of "idiopathic" NGU[9].
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PATHOGENS
- Gonococcal urethritis:5-20%
- Neisseria gonorrhoeae: 5-20% of urethritis in the U.S. (higher in inner-city populations).
- Non-gonococcal urethritis:
- Chlamydia trachomatis (CT): the 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: maybe the second most frequent cause of urethritis in the U.S. and UK. It May account for between 15%-22% of cases of acute NGU. It also has a role in chronic NGU.
- Trichomonas vaginalis: is the cause of only about 2% of cases of acute NGU but probably a higher proportion of chronic NGU.
- Risks in men for infertility, HIV.
- Ureaplasma urealyticum: biovar 2 is probably a more important cause of acute NGU than previously realized. Note that organisms can be cultured in 30-40% of asymptomatic men. Quantification of the organism may help establish a diagnosis.
- Less common: include
- Herpes simplex virus (rare in the absence of noticeable skin lesions)
- Adenovirus
- Haemophilus spp
- Yeasts, e.g., Candida spp.
- N. meningitidis
- Increasingly described in symptomatic MSM.
- Staphylococcus saprophyticus.
- Novel bacteria recently associated with bacterial vaginosis, such as Leptotrichia/Sneathia spp. may be the urethral pathogens of "idiopathic" NGU[9].
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Last updated: January 14, 2023
Citation
Fabre, Valeria. "Urethritis [Men]." Johns Hopkins ABX Guide, The Johns Hopkins University, 2023. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540571/8/Urethritis_[Men].
Fabre V. Urethritis [Men]. Johns Hopkins ABX Guide. The Johns Hopkins University; 2023. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540571/8/Urethritis_[Men]. Accessed March 30, 2023.
Fabre, V. (2023). Urethritis [Men]. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540571/8/Urethritis_[Men]
Fabre V. Urethritis [Men] [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2023. [cited 2023 March 30]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540571/8/Urethritis_[Men].
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