Diagnosis and Etiology of Nongonococcal Urethritis

The observation of more than four polymorphonuclear cells (PMN) per high-power field (hpf) in gram-stained smears of urethral secretions was found to differentiate patients with urethritis from patients without urethritis. A urethral discharge was present in 78% of patients with nongonococcal urethr...

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Bibliographic Details
Published in:The Journal of infectious diseases 1978-10, Vol.138 (4), p.445-454
Main Authors: Swartz, Stephen L., Kraus, Stephen J., Herrmann, Kenneth L., Stargel, Michael D., Brown, W. Jerry, Allen, Stephen D.
Format: Article
Language:English
Subjects:
Chlamydia trachomatis - isolation & purification
Control groups
Corynebacterium - isolation & purification
Dysuria
Etiology
Gardnerella vaginalis
Humans
Infections
Major Articles
Male
Men
Neisseria gonorrhoeae
Neutrophils
Neutrophils - microbiology
Simplexvirus - isolation & purification
Streptococcus agalactiae - isolation & purification
Symptoms
Urethritis
Urethritis - diagnosis
Urethritis - etiology
Yeasts
Yeasts - isolation & purification
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Summary:The observation of more than four polymorphonuclear cells (PMN) per high-power field (hpf) in gram-stained smears of urethral secretions was found to differentiate patients with urethritis from patients without urethritis. A urethral discharge was present in 78% of patients with nongonococcal urethritis (NGU). Dysuria without demonstrable urethral discharge and with fewer than four PMN /hpf did not appear to fit into the NGU spectrum. NGU is now defined to include men who have negative urethral cultures for Neisseria gonorrhoeae with a urethral discharge and/or more than four PMN /hpf in their urethral smears. The finding of more than four PMN /hpf in the urethral smears of 22% of asymptomatic sexually active men with more than one sexual partner (polygamous controls) suggeststhat asymptomatic NGU is not uncommon. Chlamydia trachoma tis was isolated significantly more frequently from the NGU study group than from the control group (P < 0.001). This study adds Corynebacterium vaginale (Haemophilus vaginalis) , group B streptococci, and yeasts to the list of sexually transmitted microorganisms that are not etiologic determinants of NGU.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/138.4.445