Journal of General Internal Medicine

, Volume 2, Issue 3, pp 199–203 | Cite as

Nongonococcal urethritis

Diagnosis and management
  • Linda M. Lucas
  • David L. Smith
Clinical Reviews


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Kaufman RE, Wiesner PJ. Nonspecific urethritis. N Engl J Med 1974;291:1175–7PubMedCrossRefGoogle Scholar
  2. 2.
    Bowie WR. Urethritis in males. In: Brehm JJ, Schwartz M (eds). Sexually transmitted diseases. New York: McGraw-Hill: 1984:638–50Google Scholar
  3. 3.
    Bowie WR, Holmes KK. Nongonococcal urethritis. In: Hoeprich PD (ed.). Infectious diseases. Philadelphia: Harper and Row: 1983:574–9Google Scholar
  4. 4.
    Wiesner PJ. Selected aspects of the epidemiology of nongonococcal urethritis. In: Nongonococcal urethritis and related infections. Washington DC: The American Society for Microbiology; 1977:9–10Google Scholar
  5. 5.
    Schachter J, Hanna L, Hill EC, et al. Are chlamydial infections the most prevalent venereal disease? JAMA 1975;231:1252–5PubMedCrossRefGoogle Scholar
  6. 6.
    Thompson SE, Washington AE. Epidemiology of sexually transmittedChlamydia trachomatis infections. Epidemiol Rev 1983;5:96–123PubMedGoogle Scholar
  7. 7.
    Schachter J. Clinical basis for treating presumptive chlamydial infection. West J Med 1985;143:656–7PubMedGoogle Scholar
  8. 8.
    National Institutes of Health. NIAID Study Group on Sexually Transmitted Diseases: 1980 status report. US Government Printing Office, Washington DC 1981:215–64Google Scholar
  9. 9.
    Centers for Disease Control.Chlamydia trachomatis infections—policy guidelines for prevention and control. MMWR 1985;34(suppl):53–74Google Scholar
  10. 10.
    Handsfield HH, Jasman LL, Roberts PL, et al. Criteria for selective screening forChlamydial trachomatis infection in women attending family planning clinics. JAMA 1986;255:1730–4PubMedCrossRefGoogle Scholar
  11. 11.
    Holmes KK, Johnson DW, Floyd TM, et al. Studies of venereal disease. II. Observations on the incidence, etiology, and treatment of the postgonococcal urethritis syndrome. JAMA 1967;202:131–7CrossRefGoogle Scholar
  12. 12.
    Oriel JD, Reeve P, Thomas BJ, et al. Infection withchlamydia Group A in men with urethritis due toNeisseria gonorrhoeae. J Infect Dis 1975;131:376–82PubMedGoogle Scholar
  13. 13.
    McCormack WM, Braun P, Yhu-Hsiung L, et al. The genital mycoplasmas. N Engl J Med 1973;288:78–89PubMedCrossRefGoogle Scholar
  14. 14.
    Bowie WR. Etiology and treatment of nongonococcal urethritis. Sex Transm Dis 1978;5:27–33PubMedCrossRefGoogle Scholar
  15. 15.
    Schachter J. Chlamydial infections. N Engl J Med 1978;298:428–34PubMedCrossRefGoogle Scholar
  16. 16.
    McCormack WM, Lee YH, Zinner SH. Sexual experience and urethral colonization with genital mycoplasmas—a study of normal men. Ann Intern Med 1973;78:696–8PubMedGoogle Scholar
  17. 17.
    Holmes KK, Handsfield HH, Wang SP, et al. Etiology of nongonococcal urethritis. N Engl J Med 1975;292:1199–205PubMedCrossRefGoogle Scholar
  18. 18.
    Wong JL, Hines PA, Brasher MD, et al. The etiology of nongonococcal urethritis in men attending a venereal disease clinic. Sex Transm Dis 1977;4:4–8PubMedCrossRefGoogle Scholar
  19. 19.
    Paavonen J, Kousa M, Saikku P, et al. Examination of men with nongonococcal urethritis and their sexual partners forChlamydia trachomatis andUreaplasma urealyticum. Sex Transm Dis 1978;5:93–6PubMedCrossRefGoogle Scholar
  20. 20.
    Bowie WR, Wang SP, Alexander ER, et al. Etiology of nongonococcal urethritis—evidence forChlamydia trachomatis andUreaplasma urealyticum. J Clin Invest 1977;59:735–42PubMedCrossRefGoogle Scholar
  21. 21.
    Bowie WK, Alexander ER, Floyd JF, et al. Differential response of chlamydial and ureaplasma-associated urethritis to sulphafurazole (sulfisoxazole) and aminocyclitols. Lancet 1976;2:1276–8PubMedCrossRefGoogle Scholar
  22. 22.
    Taylor-Robinson D, McCormack WM. The genital mycoplasmas. N Engl J Med 1980;302:1003–10PubMedCrossRefGoogle Scholar
  23. 23.
    McCutchan JA. Epidemiology of venereal urethritis: comparison of gonorrhea and nongonococcal urethritis. Rev Infect Dis 1984;6:669–88PubMedGoogle Scholar
  24. 24.
    Rein MF. Urethritis. In: Mandell GL, Douglas RG, Bennett JE (eds.). Infectious diseases. New York: John Wiley and Sons; 1985, 720–2Google Scholar
  25. 25.
    Swartz SL, Kraus SJ, Herrmann KL, et al. Diagnosis and etiology of nongonococcal urethritis. J Infect Dis 1978;138:445–54PubMedGoogle Scholar
  26. 26.
    Bowie WR, Pollock HM, Forsyth PS, et al. Bacteriology of the urethra in normal men and men with nongonococcal urethritis. J Clin Microbiol 1977;6:482–8PubMedGoogle Scholar
  27. 27.
    Thelin F, Wennstrom AM, Mardh PA. Contact-tracing in patients with genital chlamydial infection. Br J Vener Dis 1980;56:259–62PubMedGoogle Scholar
  28. 28.
    Jacobs NF, Kraus SJ. Gonococcal and nongonococcal urethritis in men—clinical and laboratory differentiation. Ann Intern Med 1975;82:7–12PubMedGoogle Scholar
  29. 29.
    Handsfield HH. Gonorrhea and nongonococcal urethritis — recent advances. Med Clin North Am 1978;62:925–43PubMedGoogle Scholar
  30. 30.
    Berger RE, Alexander ER, Monda GD, et al.Clamydia trachomatis as a cause of acute “idiopathic” epididymitis. N Engl J Med 1978;298:301–4PubMedCrossRefGoogle Scholar
  31. 31.
    Gartman E. Epididymitis — a reappraisal. Am J Surg 1961;101:736–41PubMedCrossRefGoogle Scholar
  32. 32.
    Harnisch JP, Berger RE, Alexander ER, et al. Etiology of acute epididymitis. Lancet 1977;1:819–21PubMedCrossRefGoogle Scholar
  33. 33.
    Hirst LW, Thomas JV, Green WR. Conjunctivitis. In: Mandell GL, Douglas RG, Bennett JE (eds.). Infectious disease. New York: John Wiley and Sons; 1985;751Google Scholar
  34. 34.
    Darougar S, Chlamydial ocular infection. J Antimicrob Chemother 1981;8:350–4PubMedCrossRefGoogle Scholar
  35. 35.
    Schachter J. Chlamydial infections. N Engl J Med 1978;298:540–9PubMedCrossRefGoogle Scholar
  36. 36.
    Quinn TC, Goodell SE, Myrtichian E, et al.Chlamydia trachomatis proctitis. N Engl J Med 1981;305:195–200PubMedCrossRefGoogle Scholar
  37. 37.
    Calin A. Reiter’s syndrome. In: Kelley WN, Hams ED, Ruddy S, Sledge CB (eds.): Textbook of rheumatology. Philadelphia: W. B. Saunders; 1985:1007–20Google Scholar
  38. 38.
    Martin DH, Pollock S, Cho-Chou K, et al.Chlamydia trachomatis infections in men with Reiter’s syndrome. Ann Intern Med 1984;100:207–13PubMedGoogle Scholar
  39. 39.
    Kousa M, Saikku P, Richmond S, et al. Frequent association of chlamydial infection with Reiter’s syndrome. Sex Transm Dis 1978;5:57–61PubMedCrossRefGoogle Scholar
  40. 40.
    Keat AC, Maini RN, Nkwazi GC, et al. Role ofChlamydia trachomatis and HLA-B27 in sexually acquired reactive arthritis. Br Med J 1978;1:605–7PubMedCrossRefGoogle Scholar
  41. 41.
    Is Reiter’s syndrome caused by chlamydia? (editorial) Lancet 1985;1:317–9Google Scholar
  42. 42.
    Gibbs RS. Sexually transmitted diseases in the female. Med Clin North Am 1983;67:221–33PubMedGoogle Scholar
  43. 43.
    Brunham RC, Paavonen J, Stevens CE, et al. Mucopurulent cervicitis — the ignored counterpart in women of urethritis in men. N Engl J Med 1984;311:1–6PubMedCrossRefGoogle Scholar
  44. 44.
    Komaroff AL. Urinalysis and urine culture in women with dysuria. Ann Intern Med 1986;104:212–8PubMedGoogle Scholar
  45. 45.
    Stamm WE. Etiology and management of the acute urethral syndrome. Sex Transm Dis 1981;8:235–8PubMedCrossRefGoogle Scholar
  46. 46.
    Tait AI, Rees E, Hobson D, et al. Chlamydial infection of the cervix in contacts of men with nongonococcal urethritis. Br J Vener Dis 1980;56:37–45PubMedGoogle Scholar
  47. 47.
    Bowie WR, Jones H. Acute pelvic inflammatory disease in outpatients: association withChlamydia trachomatis andNeisseria gonorrhoeae. Ann Intern Med 1981;95:685–8PubMedGoogle Scholar
  48. 48.
    Wasserheit JN, Bell TA, Kiviat NB, et al. Microbial causes of proven pelvic inflammatory disease and efficacy of clindamycin and tobramycin. Ann Intern Med 1986;104:187–93PubMedGoogle Scholar
  49. 49.
    Goldsmith MF. Sexually transmitted diseases may reverse the revolution. JAMA 1985;255:1665–72CrossRefGoogle Scholar
  50. 50.
    Taylor-Robinson D, McCormack WM. The genital mycoplasmas. N Engl J Med 1980;302:1063–7PubMedCrossRefGoogle Scholar
  51. 51.
    Stamm WE, Koutsky LA, Benedetti JK, et al.Chlamydia trachomatis urethral infections in men: prevalence, risk factors, and clinical manifestations. Ann Intern Med 1984;100:47–51PubMedGoogle Scholar
  52. 52.
    Hook EW, Stamm WE. Sexually transmitted diseases in men. Med Clin North Am 1983;67:235–51PubMedGoogle Scholar
  53. 53.
    Tam MR, Stamm WE, Handsfield HH, et al. Culture-independent diagnosis ofChlamydia trachomatis using monoclonal antibodies. N Engl J Med 1984;310:1146–50PubMedCrossRefGoogle Scholar
  54. 54.
    Stamm WE, Harrison HR, Alexander ER, et al. Diagnosis ofChlamydia trachomatis infections by direct immunofluorescence staining of genital secretions. Ann Intern Med 1984;101:638–41PubMedGoogle Scholar
  55. 55.
    Howard LV, Coleman PF, et al. Evaluation of chlamydiazyme for the detection of genital infections caused byChlamydia trachomatis. J Clin Microbiol 1986;23:329–32PubMedGoogle Scholar
  56. 56.
    Nettleman MD, Jones RB, Roberts SD, et al. Cost-effectiveness of culturing forChlamydia trachomatis. Ann Intern Med 1986;105:189–96PubMedGoogle Scholar
  57. 57.
    Bell TA, Grayston JT. Centers for Disease Control guidelines for prevention and control ofChlamydia trachomatis infections — summary and commentary. Ann Intern Med 1986;104:524–6PubMedGoogle Scholar
  58. 58.
    Sanders LL, Harrison HR, Washington AE. Treatment of sexually transmitted chlamydial infections. JAMA 1986;255:1750–6PubMedCrossRefGoogle Scholar
  59. 59.
    Wilcox RR. “Triple tetracycline” in the treatment of nongonococcal urethritis in males. Br J Vener Dis 1972;48:137–40Google Scholar
  60. 60.
    Bowie WR. In vitro and in vivo efficacy of antimicrobials againstChlamydia trachomatis. Infection 1982;10(suppl):46–52CrossRefGoogle Scholar
  61. 61.
    Holmes KK, Morse SA. Gonococcal infections. In: Hoeprich PD (ed.). Infectious diseases. Philadelphia: Harper and Row, 1983;580–98Google Scholar
  62. 62.
    Treatment of sexually transmitted diseases. Med Lett Drug Ther 1986:28(708):23–8Google Scholar
  63. 63.
    Rice RJ, Thompson SE. Treatment of uncomplicated infections due toNeisseria gonorrheae. JAMA 1986;255:1739–46PubMedCrossRefGoogle Scholar
  64. 64.
    Rana C, Forsyth J, Semmens K. Non-specific urethritis. Med J Aust 1978;22:409–10Google Scholar
  65. 65.
    Scheibel JH, Kristensen JK, Hentzer B, et al.: Treatment of chlamydial urethritis in men and chlamydia-trachomatis-positive female partners: comparison of erythromycin and tetracycline in treatment courses of one week. Sex Transm Dis 1982;9:128–31PubMedCrossRefGoogle Scholar
  66. 66.
    Oriel JD, Ridgway GL, Tchamouroff S. Comparison of erythromycin stearate and oxytetracycline in the treatment of nongonococcal urethritis. Scot Med J 1977;22:375–9PubMedGoogle Scholar
  67. 67.
    The National Collaborative NGU Treatment Group. Comprison of erythromycin and tetracycline for the treatment of nongonoccal urethritis in males. In: Mardh PA, et al (eds.). Chlamydial infections. Amsterdam: Elsevier Biomedical Press; 1982;253–6Google Scholar
  68. 68.
    Schachter J, Sweet RL, Grossman M, et al. Experience with the routine use of erythromycin for chlamydial infections in pregnancy. N Engl J Med 1986;314:276–9PubMedCrossRefGoogle Scholar
  69. 69.
    Alexander ER, Harrison HR, Lewis M, et al. Strategies for prevention of infant chlamydial disease. In: Mardh PA, et al. (eds.). Chlamydial infections. Amsterdam: Elsevier Biomedical Press; 1982:225–8Google Scholar
  70. 70.
    Bowie WR, Alexander ER, Stimson JB, et al. Therapy for nongonococcal urethritis — double-blind randomized comparison of two doses and two durations of minocycline. Ann Intern Med 1981;95:306–11PubMedGoogle Scholar
  71. 71.
    Stone KM, Grimes DA, Magder LS. Primary prevention of sexually transmitted diseases. JAMA 1986;255:1763–6PubMedCrossRefGoogle Scholar

Copyright information

© Society for Research and Education in Primary Care Internal Medicine 1987

Authors and Affiliations

  • Linda M. Lucas
    • 1
  • David L. Smith
  1. 1.Ambulatory Care and Medical ServicesVeterans Administration Medical CenterPortland

Personalised recommendations