Urethral discharge

Introduction The urethral discharge secretion is one of the symptoms manifested by urethritis, and the secretion smear and culture can not detect a genitourinary system infectious disease of Neisseria gonorrhoeae. Because female patients not only have urinary tract inflammation, but also cervical inflammation, it is also called "non-specific reproductive tract infection (NSGI). It is mainly caused by infection with Chlamydia trachomatis or Ureaplasma urealyticum, and a few can also be caused by Trichomonas vaginalis. Caused by Candida albicans and herpes simplex virus, etc. It is one of the common sexually transmitted diseases.

Cause

40% to 50% of non-gonococcal urethritis is caused by Chlamydia trachomatis. Chlamydia is an intracellular parasitic microorganism between bacteria and virus, with a diameter of 250-500 nm. It has been detected by micro-immunofluorescence to detect at least 15 serotypes of Chlamydia, of which type 8 (D, E, F, G, H, 1, J, K) have been shown to be associated with urethritis. Chlamydia is not heat-resistant, rapidly loses its infectivity at room temperature, and can be killed at 50 ° C for 30 minutes. 30% of non-gonococcal urethritis is caused by urea-decomposing mycoplasma. The urea-decomposing mycoplasma is extremely tiny in the shape of a club with a diameter of only 200 nm. It is often parasitic on the human urethral epithelium and has the property of decomposing urea into ammonia. Can live independently outside the cell and have weak resistance to the external environment. It can be killed in 15 minutes at 45 °C. 10% to 20% of non-gonococcal urethritis can be caused by other pathogens. Such as trichomoniasis, Candida albicans, herpes virus, Escherichia coli, Streptococcus, Staphylococcus aureus, human papillomavirus, yeast, anaerobic Gram-negative bacilli and the like.

an examination

Related inspection

Urethral discharge examination urethral examination urine routine

Clinical diagnosis

Have a history of unclean sexual intercourse, vaginal, urethral secretions and urinary burning pain, take urethra, cervical secretion smear and culture to check for gonococcal negative, urethral secretion smear in the 1000-fold microscope to see polymorphonuclear leukocytes> 5 , can be initially diagnosed as non-gonococcal urethritis.

2. Laboratory diagnosis

The diagnosis of NGU relies on laboratory tests. 1 The method for the detection of trachoma is to use tissue culture of McCoy cells treated with cycloheximide. In recent years, pathogen antigens in specimens have been directly detected by enzyme-linked immunosorbent assay or fluorescence technique. 2 Ureaplasma urealyticum culture and serological identification.

Differential diagnosis

Urethritis should first be distinguished from gonorrhea urethritis, as well as symptoms of purulent discharge. Gonorrhea urethritis is a sexually transmitted disease with specific infection. The urethra has purulent secretions. The pus smear staining shows that there are Gram-negative diplococcus in the lobular granulocytes.

Secondly, it should be distinguished from non-gonococcal urethritis and trichomonas urethritis. It is easy for women to find trichomoniasis in the vagina, but it is not easy for men to find trichomoniasis. It is often required under the foreskin, urethral secretions, prostatic fluid and urine. Check for trichomoniasis and make a diagnosis. In addition to urethritis, reiter syndrome has conjunctivitis and arthritis.

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