Color Atlas of Modern Diagnosis and Treatment of Sexually Transmitted Diseases (Revised Edition)

Author: Liao Yuanxing
Publisher:
Publish Date: 2005-02-01
Features:
Six. Nongonococcal Urethritis (NGU)
The onset process of NGU is similar to that of gonococcal urethritis. The local glands become red, swollen, hot, and painful, with tenderness (Figure 3-15). Sometimes, abscesses may form, accompanied by fever, fatigue, and swollen groin lymph nodes. However, the symptoms are milder than those of gonococcal infection. Therefore, if a patient presents with a mild gonococcal infection and more severe NGU, it can be difficult to distinguish clinically. In such cases, a comprehensive diagnosis should be made by considering the patient's history of cervical inflammation, vaginitis, etc. If necessary, a bacterial examination of secretions or puncture fluid should be performed for confirmation.
Seven. NGU-Related Pelvic Inflammation
Due to the difficulty in detecting or treating NGU in females, many patients develop NGU-related pelvic inflammation through infection from the cervix. This includes NGU-related salpingitis, endometritis, and tubo-ovarian cysts. Some studies have found that 30% of patients with acute salpingitis test positive for Chlamydia trachomatis, while others have identified ureaplasmal urealyticum as the cause. However, the symptoms are generally mild, with occasional lower abdominal pain that worsens after menstruation or excessive sexual activity. Due to the slow progression of the disease, it is often overlooked. The condition is frequently discovered when the husband or other sexual partner seeks medical attention for NGU. Tubal inflammation can lead to infertility, while other pelvic inflammatory conditions may result in ectopic pregnancy or miscarriage.
Eight. NGU-Related Conjunctivitis
NGU-related conjunctivitis almost always occurs in newborns. If the mother has NGU in her reproductive tract (currently primarily caused by Chlamydia trachomatis), about 35% to 50% of newborns may develop eye infections during delivery. Symptoms typically appear 1 to 2 weeks after birth, most commonly affecting one eye. The main symptom is conjunctival congestion, with occasional purulent mucous discharge. Infants may become restless. However, some cases may be asymptomatic. If not treated promptly and correctly, it can become chronic, leading to repeated episodes and scarring, which may result in blindness in severe cases. A sample from the conjunctiva can reveal intracellular inclusions, and if possible, Chlamydia trachomatis can be cultured for definitive diagnosis.
Nine. NGU-Related Proctitis
NGU-related proctitis is similar to gonococcal proctitis but tends to be less severe and more recurrent. Diagnosis and treatment are more challenging than for gonococcal proctitis. Therefore, when suspecting this condition, a thorough medical history and symptom assessment, along with detailed examinations and bacterial testing, are necessary for appropriate treatment.
Ten. NGU in Children
In addition to conjunctivitis, pharyngitis, or pneumonia in newborns, NGU in children is more commonly seen in male and female urethritis and vaginitis, with male children often exhibiting phimosis. The symptoms of urethritis are similar to those in adults, including varying degrees of thin purulent discharge, localized congestion, and mild edema at the urethral orifice. Male children often have redness of the prepuce and glans. Female children may have redness of the vaginal orifice with pale yellow discharge. Vaginitis symptoms are primarily characterized by burning and itching. Children with urethritis-vaginitis often have parents with a history of NGU, suggesting transmission through indirect contact. However, some cases have unclear origins. Therefore, in addition to medical history and family conditions, bacterial testing is crucial for definitive diagnosis. The pathogens are often Chlamydia trachomatis and ureaplasmal urealyticum.
Eleven. NGU-Related Pneumonia
This condition is more common in newborns and is primarily caused by Chlamydia infection. Women with the disease may...