Gonorrhea and Nongonococcal Urethritis

Urethritis may present as a urethral discharge or simply dys-uria. Family physicians should suspect urethritis in patients with symptoms of UTI, pyuria, presence of leukocyte esterase, and negative urine culture. N. gonorrhoeae and C. trachomatis are the most important causative organisms. Gonococcal urethritis is typically symptomatic. Chlamydia causes most cases of nongonococcal urethritis (CDC, 2006). Various treatment options exist (see Table 40-10). Fluoroquinolones are no longer recommended as a treatment option due to resistance rates (del Rio et al., 2007). Patients with gonorrhea who are not ruled out for chlamydia should be treated for it because co-infection is common (CDC, 2006).

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