(A) Clinical symptoms
1. The incubation period of non-gonococcal urethritis is 10-20 days.
2. The onset of the disease is not as urgent as gonorrhea, and the symptoms are delayed, sometimes lighter, but lighter than gonorrhea. About 50% of patients have symptoms such as painful urination and itchy urethra. It is easy to be missed at the initial diagnosis. In men, non-gonococcal urethritis is characterized by urethral discomfort, itching, burning or stinging, urethral redness and swelling, and urethral discharge that is mostly plasma-like and thin, with a “mucus” phenomenon in the morning.
Non-gonococcal urethritis in women is characterized by inflammation and erosion of the cervix, increased discharge, a majority of lobulated leukocytes in the cervical discharge (more than 10 per field of view under high magnification), vaginal and vulvar itching, and lower abdominal discomfort. Note: Some patients may be asymptomatic or have atypical symptoms and are easily missed. The cervical discharge has most lobulated leukocytes (more than 10 per field of view under high-powered microscopy).
3. The urethral discharge is scanty, thin, mucous or mucopurulent. Longer periods without urination (such as morning rise) can overflow a small amount of thin discharge from the external urethral opening. Sometimes it only shows up in the morning when the scab film seals the urethral orifice or contaminates the underwear. During examination, it is necessary to squeeze the anterior urethra from back to front before a little discharge may come out from the urethral orifice. Sometimes the patient has symptoms without discharge, but also asymptomatic but with discharge.
4, often infected with gonorrhea at the same time. In the former case, gonorrhea symptoms appear first, and after anti-gonorrhea treatment, gonococcus is killed by penicillin, while chlamydia and mycoplasma still exist. The disease develops 1-3 weeks after the infection. Clinically, it is easy to be mistaken for gonorrhea not cured or relapse.
5.Improper treatment or untimely treatment can cause complications (1%). Such as acute epididymitis, prostatitis, colitis, pharyngitis. Female cervicitis, cervical erosion, vestibular adenitis, vaginitis, tubitis, pelvic inflammatory disease, ectopic pregnancy, infertility, etc.
6. Conjunctivitis can occur in newborns through the infected birth canal, 3-13 d after birth, with or without mucopurulent discharge from the eye. However, most do not invade the cornea. Pneumonia can occur 2-3 weeks after birth. It is characterized by worsening symptoms and shortness of breath, but no fever. Half of the children have conjunctivitis.
7. Very few patients may develop Reifer’s syndrome: uveitis, arthritis, keratitis, conjunctivitis and rash.
(II) Diagnosis
1.History of unclean sexual intercourse, incubation period and symptoms.
2. Smear of urethral discharge and culture to exclude gonococci, Candida and other bacterial infections. Smear with a large number of white blood cells, more than 10-15/400x, more than 5/1000x microscopic examination.
3, urethral discharge or cervical smear, monoclonal Chlamydia fluorescence antibody examination or culture. Specimen taking method: male more than 2h without urination, cotton swab inserted into the urethra 2-4cm, gently rotate 5s, placed 2-3s, and then removed for culture. Women use speculum to fully expose the violent cervix, the first swab wipes off the surface secretion of the cervix, the second swab is inserted into the cervix 1-2cm, rotate for 10s, stop for 2-3s, remove the swab, do not touch the vaginal wall.
( C) Comorbidity
In men, the main comorbidities are epididymitis, prostatitis and Reiter syndrome; in women, it is mainly tubitis, pelvic inflammatory disease, ectopic pregnancy and infertility.
(IV) Criteria for judging cure
The treatment should be followed up and rechecked one week after the end of treatment. Cure criteria.
1, disappearance of clinical symptoms for more than 1 week, no discharge from the urethra, or white red cells ≤4/100x microscopy in the discharge.
2, urine clarification, sediment microscopy negative.
3, urethral (cervical) specimens negative for chlamydia and mycoplasma (when available).