non-gonococcal urethritis
Introduction
Introduction to non-gonococcal urethritis Non-gonococcal urethritis (NGU) is a sexually transmitted disease (STD) caused by Chlamydia trachomatis, Ureaplasma urealyticum, and the like. There is clinical manifestation of urethritis, but no gonococcal bacteria are found in the secretions, and there is no gonococcal growth in bacterial culture. Female patients often have genital inflammation such as cervicitis, so they are also called non-specific reproductive tract infections in women. Because the one-time contact can simultaneously infect Neisseria gonorrhoeae and Chlamydia trachomatis, the incubation period of the latter is longer than that of the former. After the gonorrhea is cured, the symptoms of NGU appear again. The name is ureteritis after gonorrhea, which is actually the performance of NGU. basic knowledge The proportion of illness: 0.0003% Susceptible people: more common in women Mode of infection: non-infectious Complications: orchitis prostatitis pelvic inflammatory disease
Cause
Cause of nongonococcal urethritis
Trauma infection (15%):
If you recognize that there is a wound on your body, the non-leaching virus will invade the patient through the wound on the skin and mucous membrane. After intrusion, it will lie in the patient's body for a period of time, and after a certain period of time, it will become ill, causing inflammation infection.
Low immunity (10%):
People with weaker immunity are prone to various diseases if they do not pay attention to maintenance in daily life. Some people are often very susceptible to infection when they have low immunity, so they should be taken seriously.
Exposure to secretions (20%):
Non-leaching contagious is very strong, if the uninfected person comes into contact with the patient's private clothing or the use of underwear, bedding, tub, towel, toilet seat through the patient with non-gonococcal urethritis It is also indirectly contagious.
Unclean sex life (20%):
Non-leaching is directly transmitted through sexual life, as long as it is sexually transmitted with people who have non-leaching, it will be contagious, and its contagiousness is very strong. Therefore, it is necessary to pay attention to it, and it is impossible to have a bad life such as promiscuity and prostitution.
Infection of the birth canal (10%):
If the pregnant woman suffers from non-leaching, the non-leaching virus will be transmitted to the newborn through the birth canal, causing the newborn to carry a non-leovirus when born, and the non-leaching will be transmitted to the fetus through the placenta and amniotic fluid, causing the fetus to die. .
Prevention
Non-gonococcal urethritis prevention
1. Promote self-love and eradicate sexual chaos.
2. The patient must not have sexual relationship with any person before he is cured.
3. Individual prevention of infection is similar to gonorrhea.
4, the patient should be dedicated to the bathtub, bath towels, together with the underwear should be boiled and disinfected frequently.
5. Treating a sexual partner.
Complication
Non-gonococcal urethritis complications Complications orchitis prostatitis pelvic inflammatory disease
The main male comorbidities are epididymitis, prostatitis and Reiter syndrome; women are mainly salpingitis, pelvic inflammatory disease, ectopic pregnancy and infertility.
Symptom
Non-gonococcal urethritis symptoms Common symptoms Urethral itch urethra secrete mucus or... Urinary pain urethra discharge
Clinical symptoms
1. The incubation period for non-gonococcal urethritis is 10-20 days.
2, onset is not as urgent as gonorrhea, symptoms procrastination, light and heavy, but lighter than gonorrhea, about 50% of patients have urinary pain, urethral itching and other symptoms, easily diagnosed at the time of initial diagnosis, male non-gonococcal urethritis Urinary tract discomfort, itching, burning or tingling, urethra redness, urethral secretions are mostly serous, thin, there is a "life" phenomenon in the morning, female non-gonococcal urethritis manifests as inflammation and erosion of the cervix, increased secretions There are most lobulated leukocytes in the cervical secretions (more than 10 per field under high magnification), vaginal and genital itching, lower abdominal discomfort, note: some patients may be asymptomatic or atypical symptoms, easily missed, cervical secretions There are many lobulated leukocytes (more than 10 per field under high power).
3, less urethral secretions, thin, mucous or mucopurulent, do not urinate for a long time (such as morning) urethral orifice can spill a small amount of thin secretions, sometimes only for morning decidua seal urethra or pollution Underpants, when checking, it is necessary to press the anterior urethra from the back to the front to squeeze a little secretion from the urethra. Sometimes the patient has symptoms without secretions, and can also have asymptomatic secretions.
4, often with gonorrhea at the same time infection, the former first symptoms of gonorrhea, after treatment of anti-gonorrhea, Neisseria gonorrhoeae was killed by penicillin, while Chlamydia, mycoplasma still exists, after 1-3 weeks of infection, clinically easy to be mistaken Gonorrhea is not cured or relapses.
5, improper treatment or treatment can not cause complications (1%), such as acute epididymitis, prostatitis, colitis, pharyngitis, female cervicitis, cervical erosion, vestibular gland inflammation, vaginitis, salpingitis, pelvic inflammatory disease , ectopic pregnancy, infertility, etc.
6, the newborn through the infected birth canal, 3-13d after birth can occur conjunctivitis, the eyes have mucopurulent secretions, but also no secretions, but not more invading the cornea, 2-3 weeks after birth can occur Pneumonia, symptoms continue to increase, shortness of breath is characteristic, but not fever, half of them have conjunctivitis.
7, a very small number of patients may be associated with Reifer syndrome: urethritis, arthritis, keratitis, combined with membranous inflammation and rash.
Examine
Non-gonococcal urethritis examination
(1) The secretion smear and culture of Neisseria gonorrhoeae were negative, while the smear microscopy showed more than 4 polymorphonuclear leukocytes or morning urine in the oil microscope (1000 times) field, and 15 ml of the anterior segment of urine precipitated at high magnification ( 400 times) In view of the field, more than 15 polymorphonuclear leukocytes per field have diagnostic significance.
(2) Conditional examination for pathogens such as Chlamydia trachomatis and Ureaplasma urealyticum.
Diagnosis
Diagnosis and identification of nongonococcal urethritis
diagnosis
1, history of unclean sexual intercourse, incubation period and symptoms.
2, urethral secretion smear and culture to exclude gonococcal, Candida and other bacterial infections, smear with a large number of white blood cells, 10-15 more / 400 times, more than 5 / 1000 times microscopy.
3, urethral secretions or cervical smear, monoclonal chlamydia fluorescent antibody examination or culture, specimens take: male more than 2h does not urinate, cotton swab inserted into the urethra 2-4cm, gently rotate 5s, placed 2-3s, then take out culture Women use voyeurism to fully expose the cervix. The first swab wipes off the surface secretion of the cervix. The second swab is inserted into the cervix 1-2cm, rotated for 10s, stopped for 2-3s, remove the swab, do not touch the vagina. wall.
The disease should be distinguished from gonococcal urethritis. The latter has a short incubation period of 3 days to 5 days. The urinary pain is more serious. The secretions are mostly purulent, the amount is more, the gonococcal test is positive, and the secretion of NGU is Mostly serous or mucopurulent, thinner, less amount, can not find gonococcus.
Differential diagnosis
Non-gonococcal urethritis and gonorrhea identification:
(1) The pathogens are different. The pathogens of non-gonococcal urethritis are Chlamydia trachomatis and Mycoplasma, Candida albicans, Trichomonas vaginalis, etc., and the pathogen of gonorrhea is Gonorrhea.
(2) Different clinical symptoms, the clinical symptoms of non-gonococcal urethritis are milky white secretions, which are manifested in the form of chronic urethritis; and the onset of gonorrhea is a large amount of yellow purulent discharge from the urethra to acute urethra The form of inflammation is manifested.
