Gonorrhea and urethritis

Abstract

Urethritis, with typical symptoms such as dysuria and urethral discharge, is caused by bacteria, fungi, protozoa, and viruses that are often sexually transmitted. Ascending inflammations can lead to sterility and severe clinical pictures. Pathogen characteristics and patient-specific factors determine the course of the disease. If a sexually transmitted infection (STI) is detected, an examination for further STIs should be performed. Gonorrhea affects the mucous membranes of the urogenital and anal tracts, the pharynx, and the conjunctiva. The development of single- and multidrug resistance is a cause for concern. Currently, dual therapy with ceftriaxone and azithromycin is recommended. Urogenital Chlamydia trachomatis infection (Serovars D-K) is one of the most common STIs. In the case of proctitis, LGV infection should be ruled out. Doxycycline or azithromycin are suitable for treatment. Genital Mycoplasma genitalium infections often occur as persistent or recurrent urethritis. Treatment recommendations vary widely because of the increasing development of resistance. Trichomoniasis is considered the STI with the highest prevalence worldwide, but is low in Western European countries. The drug of choice is metronidazole.