最后审阅: 17 九月 2021
最后更新: 16 二月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 尿道分泌物
  • 尿道刺激症状或瘙痒
  • 排尿困难

其他诊断因素

  • 睾丸疼痛
  • 无附睾触痛和/或肿胀
  • 无盆腔疼痛(女性)
  • 无脓疱疹或瘀点样皮疹
  • 无关节炎
  • 无眼部炎症

危险因素

  • 15-24 岁
  • 女性
  • 男男性行为者
  • 社会经济地位低
  • 新的或多个性伴侣
  • 既往或目前患有性传播疾病
  • 避孕套使用行为模式不一致
  • 包皮环切

诊断性检查

首要检查

  • 尿道分泌物和/或尿沉渣革兰氏染色
  • 核酸扩增试验 (NAAT)
  • 尿道分泌物培养
  • 氢氧化钾处理尿道分泌物
  • HIV 检查
  • VDRL

需考虑的检查

  • 尿液分析和培养
  • 尿道分泌物湿片镜检(女性
  • 针对阴道毛滴虫的尿液或尿道/阴道拭子 NAAT 检测和培养
  • 针对非淋球菌性、非衣原体微生物的 NAAT

治疗流程

撰稿人

作者

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

利益声明

SM has stocks in Bristol-Myers Squibb, Forty Seven Inc, and Geron Corp. He has received funding from Gilead Sciences. SM is an author of a number of references cited in this topic.

鸣谢

Dr Sheldon Morris would like to gratefully acknowledge Dr Christina Bailey, a previous contributor to this topic. CB declares that she has no competing interests.

同行评议者

Vani Dandolu, MD, MPH

Associate Professor

Ob/Gyn and Urology

Director

Division of Urogynecology

Associate Residency Program Director

Temple University Hospital

Philadelphia

PA

利益声明

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

利益声明

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

利益声明

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

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