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Nonspecific Genitourinary Infections - Causes, Symptoms and Treatment
What are Nonspecific Genitourinary Infections?
Nonspecific genitourinary infections, including nongonococcal urethritis (NGU) in males and mild vaginitis and cervicitis in females, are a group of infections with similar manifestations that are not linked to a single organism. These sexually transmitted infections have become more prevalent since the mid-1960s. They are more widespread than gonorrhea and may be the most common sexually transmitted diseases in the United States. The prognosis is good if sexual partners are treated simultaneously.
What are the Causes of Nonspecific Genitourinary Infections?
Nonspecific genitourinary infections are spread primarily through sexual intercourse. In males, NGU commonly results from infection with Chlamydia trachomatis or Ureaplasrna urealyticum. Less frequently, infection may be related to preexisting strictures, neoplasms, or chemical or traumatic inflammation. Some cases remain unexplained.
Although less is known about nonspecific genitourinary infections in females, chlamydial organisms may also cause these infections. A thin vaginal epithelium may predispose prepubertal and postmenopausal females to nonspecific vaginitis.
What are the Signs and Symptoms of Nonspecific Genitourinary Infections?
Nongonococcal urethritis occurs 1 week to 1 month after coitus, with scant or moderate mucopurulent urethral discharge, variable dysuria, and occasional hematuria. If untreated, NGU may lead to acute epididymitis. Subclinical urethritis may be found on physical examination, especially if the sex partner has a positive diagnosis .
Females with nonspecific genitourinary infections may experience persistent vaginal discharge, acute or recurrent cystitis for which no underlying cause can be found, or cervicitis with inflammatory erosion.
Both males and females with nonspecific genitourinary infections may be asymptomatic but show signs of urethral, vaginal, or cervical infection on physical examination.
Diagnosis for Nonspecific Genitourinary Infections
In males, microscopic examination of smears of prostatic or urethral secretions shows excess polymorphonuclear leukocytes but few, if any, specific microbes.
In females, cervical or urethral smears also reveal excess leukocytes and no specific microbes. "Clue cells" (normal epithelial cells covered with bacteria that appear stippled) are diagnostic.
Differential diagnoses include gonorrhea and urinary tract infection.
Treatment for Nonspecific Genitourinary Infections
Therapy for both sexes consists of a single 1 g oral dose of azithromyein (Zithromax) or doxycycline 100 mg orally twice a day for 7 days. If the infection recurs or persists, metronidazole 2 g orally as a single dose with erythromycin for 7 days is recommended. For females, treatment may also include application of a sulfa vaginal cream.
Special Considerations and Prevention Tips for Nonspecific Genitourinary Infections
1. Tell female patients to clean the pubic area before applying vaginal medication and to avoid using tampons during treatment.
2. Make sure the patient clearly understands and strictly follows the dosage schedule for all prescribed medications.
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