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Urethritis

最后审阅: 20 Aug 2025
最后更新: 02 Jan 2025

小结

Definição

História e exame físico

Principais fatores diagnósticos

  • urethral discharge
  • urethral irritation or itching
  • dysuria
Detalhes completos

Outros fatores diagnósticos

  • orchialgia
  • absence of epididymal tenderness and/or swelling
  • absence of pelvic pain (women)
  • absence of pustular or petechial rash
  • absence of arthritis
  • absence of eye inflammation
Detalhes completos

Fatores de risco

  • ages 15 to 24 years
  • female sex
  • men who have sex with men
  • new or multiple sex partners
  • prior or current STI
  • inconsistent condom use
  • circumcision
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • Gram stain of urethral discharge and/or urine sediment
  • nucleic acid amplification tests (NAAT)
  • culture of urethral discharge
  • potassium hydroxide prep of urethral discharge
  • HIV test
  • syphilis test
Detalhes completos

Investigações a serem consideradas

  • urinalysis and culture
  • wet mount of urethral discharge (women)
  • NAAT and culture of urine or urethral/vaginal swab for Trichomonas vaginalis
  • NAAT for other organisms
Detalhes completos

Algoritmo de tratamento

AGUDA

initial Gram stain suggestive of gonorrhea: nonpregnant

initial Gram stain suggestive of gonorrhea: pregnant

initial Gram stain not suggestive of gonorrhea: nonpregnant

initial Gram stain not suggestive of gonorrhea: pregnant

CONTÍNUA

recurrent or resistant urethritis

Colaboradores

Autores

Sheldon Morris, MD, MPH

Assistant Professor

Division of Infectious Diseases

Department of Medicine

UCSD Antiviral Research Center

Division of Family Medicine

Department of Family and Preventive Medicine

UCSD La Jolla Family and Sports Medicine

San Diego

CA

Declarações

SM has received funding from NIH, CHRP, CIRM, NASA, and Visby Medical. SM owns stock in Bristol Myers Squib and is the founder of Aspera Biomedicines. SM is an author of a number of references cited in this topic.

Agradecimentos

Dr Sheldon Morris would like to gratefully acknowledge Dr Christina Bailey, a previous contributor to this topic.

Declarações

CB declares that she has no competing interests.

Revisores

Vani Dandolu, MD, MPH

Associate Professor

Ob/Gyn and Urology

Director

Division of Urogynecology

Associate Residency Program Director

Temple University Hospital

Philadelphia

PA

Declarações

VD declares that he has no competing interests.

Khalil Ghanem, MD, PhD

Assistant Professor of Medicine

Associate Fellowship Program Director

Division of Infectious Diseases

Johns Hopkins University School of Medicine

Baltimore

MD

Declarações

KG declares that he has no competing interests.

Christopher Fairley, PhD

Professor of Sexual Health

University of Melbourne

Director

Melbourne Sexual Health Centre

Carlton

Victoria

Australia

Declarações

CF is an author of a number of references cited in this topic. CF has received program grants of 6 figures US$.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021. Jul 2021 [internet publication].Texto completo

Centers for Disease Control and Prevention. National overview of STIs in 2023. Nov 2024 [internet publication].Texto completo

European Association of Urology. Guidelines on urological infections. 2023 [internet publication].Texto completo

Horner PJ, Blee K, Falk L, et al; International Union against Sexually Transmitted Infections. 2016 European guideline on the management of non-gonococcal urethritis. Int J STD AIDS. 2016 Oct;27(11):928-37.Texto completo

British Association for Sexual Health and HIV. Urethritis and cervicitis. May 2023 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Urethritis images
  • Differentials

    • Urinary tract infection
    • Candida balanitis or vaginitis
    • Noninfectious urethritis
    Mais Diagnósticos diferenciais
  • Guidelines

    • Guidelines on urological infections
    • 2021 European guideline on Mycoplasma genitalium infections
    Mais Guidelines
  • Patient information

    Chlamydia

    Gonorrhea

    More Patient information
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