(Disclaimer: This article is only for popular science purposes, in order to protect the privacy of patients, the relevant information in the following content has been processed) Abstract: In daily life, gonococcal urethritis is more common in genitourinary infections, belonging to a kind of sexually transmitted diseases. 18-year-old boy after unclean sex, the urethral orifice began to appear purulent secretion, secretion of yellowish-green color, accompanied by a fishy smell. After outpatient examination, he was diagnosed with gonococcal urethritis and was given medication for treatment. After 3 weeks of medication, the patient’s indicators returned to normal, and the symptoms of burning and pain in the urethra during urination disappeared, reaching the standard of cure. Basic information] Male, 18 years old [Type of disease] Gonococcal urethritis [Hospital] The First People’s Hospital of Zhengzhou City [Time of consultation] December 2021 [Treatment plan] Medication (levofloxacin tablets, hot gonorrhea granules) [Treatment cycle] 3 weeks of medication, with weekly outpatient review [Treatment effect] Symptoms disappeared, and the routine urinalysis and culture of urine were normal I. Initial interview Patient’s self-report: In the last 2 days, when urinating, there was burning and pain in the urethra, accompanied by pus flowing from the urethra, which was less the day before yesterday, but more and more pus flowed from yesterday to today, and he came to our hospital because he was afraid. Physical examination: no back pain, abdominal pain, fever, nausea, vomiting and other symptoms. In the perineal area and underwear, pus crusts were found, and there was pus discharge from the urethra. After squeezing the urethra, more pus discharge could be squeezed out, which was yellowish-green in color and accompanied by a fishy odor. The patient was asked in detail whether he had a similar medical history and a history of urologic disease, which he denied. Asked whether the patient has unclean sex, the patient said: 5 days ago, had sex, during which did not use a condom. Combined with the clinical manifestations, physical examination results, preliminary confirmation of the above symptoms caused by this sex life, so the patient for routine urinalysis, urethral secretion smear microscopy, urethral secretion culture and other related examinations. After routine urinalysis, microscopic examination of urethral secretion smear and culture of urethral secretion, the examination results showed that: routine urinalysis: leukocyte count: 2039/μL; smear of urethral secretion: gram-negative diplococcus (+), which was initially considered as gonococcal urethritis. Since the patient had no history of antibiotic allergy, he was given levofloxacin tablets and feverfew granules for treatment. After 3 days of medication, the patient complained of some relief of discomfort, and the culture of urethral secretion was performed, and the results still showed the growth of gram-negative diplococci. Since this species is sensitive to levofloxacin, the patient was advised to continue oral medication. 7 days later, the urine routine and urethral secretion culture were reviewed, and the results showed that: urine routine: leukocytes decreased to 278/μL, and the culture of urethral secretion did not show any specific bacterial growth. Squeezing the urethra, it was found that there was still a small amount of secretion, so the patient was instructed to continue to take levofloxacin tablets, and repeat the examination after 7 days. Third, the therapeutic effect The treatment cycle of gonococcal urethritis is usually 7 days, but when the patient was rechecked after taking the medicine for 7 days, the leukocytes in the urine were still high, so the patient was instructed to continue to take levofloxacin tablets orally for 7 days in order to achieve the curative effect, otherwise it would be easy to relapse. After taking the medicine again for 7 days, the patient came for review again, and there was no secretion in the urethra when squeezed, and the burning and itching symptoms of the urethra were obviously relieved, with occasional itching of the urethra only when not urinating. The urine routine was reviewed and found that the white blood cells in the urine returned to normal, and the culture of urethral secretion did not show any special bacterial growth, which reached the standard of clinical cure. The patient was asked to continue to drink more water, continue to take oral fever gonorrhea granules for 7 days, 7 days later telephone follow-up, the patient’s symptoms have completely disappeared, the treatment effect is good. Fourth, precautions I am glad that after a series of treatment, the patient finally recovered completely. However, since gonococcal urethritis is a sexually transmitted disease and often associated with unclean sex, patients still need to pay attention to the following situations in the follow-up: 1. In daily life, you should keep clean and avoid unclean sexual intercourse. If you can’t determine whether it is safe to have sex, pay attention to protect yourself and use condoms for protection, which can effectively avoid the occurrence of sexually transmitted diseases; 2, in daily life, maintain good habits, keep the perineum clean and dry, underwear and other intimate apparel should be washed every day, exposed to sunlight or disinfected in a timely manner, to prevent cross-infections with family members; 3, lifestyle habits, should be to drink more water, more Urination, prohibition of alcohol during the treatment period, as little as possible spicy, stimulating food, to avoid recurrence or aggravation of the disease. Fifth, personal feelings Clinically, most of the non-specific urethritis is mostly caused by mycoplasma infection, most patients have mild symptoms of urethral pain during urination, and the presence of dilute urethral secretion, small amount, no odor, and it is common to see in the morning. Gonococcal urethritis belongs to a kind of sexually transmitted diseases, the patient before the onset of the disease, there is a history of unclean sex, the urethra continues to secrete yellowish-green purulent mucous secretion, accompanied by a fishy odor. And urine routine white blood cell count is very high, urinary pain symptoms are more serious. In this case, the patient was diagnosed with gonococcal urethritis precisely because of the history of unclean sex and the symptoms of gonococcal urethritis. Clinically, for urological diseases, it is often necessary to make a comprehensive judgment based on the results of urethral secretion culture, combined with the patient’s past sexual history. Some patients may have two pathogens at the same time, it is necessary to use drugs according to the results of drug sensitivity, and repeat urine routine and urethral secretion culture, until the urine white blood cell count is normal, the urethral secretion culture does not see bacterial growth, will be cured. Discontinuing the medication without cure may result in recurrence of the disease.