Cases reported "Urethritis"

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1/5. Adenoviral non-gonococcal urethritis.

    Adenoviruses infect mucous membranes, including - on rare occasions - the urethra. Adenoviruses should therefore be considered as yet another cause of chlamydia-negative non-gonococcal urethritis. The following case illustrates the dilemma posed in a patient with conjunctivitis and urethritis.
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ranking = 1
keywords = conjunctivitis
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2/5. Can chlamydial conjunctivitis result from direct ejaculation into the eye?

    The majority of cases of chlamydial conjunctivitis are thought to result from autoinoculation by the patient of infected genital secretions from themselves or their sexual partners. We noted that some patients had developed symptoms following direct ejaculation into the affected eye. We describe four cases of chlamydial conjunctivitis following ejaculation of semen directly into the eye, which have not been previously described. In only one case was chlamydia detected in the genital tract. In three cases, there was no evidence of genital chlamydial infection; the sources of the eye infection being either from infected genital material of their sexual partners transferred by hands to the eyes, or more likely from direct ejaculate inoculation. It is likely that this mode of transmission is underestimated as a history of ejaculation into the conjunctiva is not normally asked for.
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ranking = 6
keywords = conjunctivitis
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3/5. Dual infection of the conjunctiva with herpes simplex virus and chlamydia trachomatis.

    We describe a homosexual man with simultaneous infection of the conjunctiva by herpes simplex virus and chlamydia trachomatis. This dual infection was associated with a genital and disseminated herpes simplex virus infection as well as asymptomatic chlamydial infection of the rectum and "nonspecific" urethritis. The findings in this case show the importance of laboratory investigation in cases of conjunctivitis associated with genital infection.
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ranking = 1
keywords = conjunctivitis
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4/5. Chlamydial infection in a family.

    In a family comprising parents and two daughters, chlamydia trachomatis (CT) was observed to be the infective agent causing urethritis in the father and conjunctivitis in the newborn. CT was probably a trigger factor in Reiter's syndrome (RS) in the mother, who suffered from arthritis, microscopic pyuria and hematuria, cervicitis and ocular manifestations. The elder daughter's mucocutaneous manifestations, probably keratodermia blennorrhagica, broke out simultaneously with chlamydial infections in the other members of the family. Later she developed joint pains, conjunctivitis and vulvitis. The elder daughter and the father are HLA-B27 negative, whereas the mother is HLA-B27 positive. With this study we would like to emphasize the importance of observing the microbial environment in the family in the etiology of rheumatic disease. Simultaneous treatment of infections in family members might benefit the clinical course of rheumatic disease.
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ranking = 2
keywords = conjunctivitis
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5/5. epidemiology of infection by serotypes D to K of chlamydia trachomatis.

    Non-specific urethritis (NSU) is a sexually transmitted disease; 50% of cases are due to chlamydia trachomatis, so that this is the commonest sexually transmitted infection in the developed world. Chlamydial infection is now readily diagnosable and the evidence increasingly suggests that it is underdiagnosed. Chlamydial conjunctivitis (in the newborn baby or the adult) in the developed world is a complication of sexually transmitted genital infection by C trachomatis and it indicates a large reservoir of such infections. Because of the association of sexually transmitted diseases, systemic treatment for such chlamydial conjunctivitis should not be given until full genital and serological investigators have been carried out. Chlamydial infection causes serious complications (that were formerly often thought to be gonococcal), such as epididymitis in young men and salpingitis on young women. It may cause local complications in the eye of the newborn baby and even pneumonia in babies and fatal endocarditis in adults. The diagnosis of NSU should lead to the correct treatment of the male patient and of his sexual partners. It is the promiscuous woman, who does not have a regular sexual partner to report back to her that he has NSU, who is at particular risk of undiagnosed chlamydial infection. Routine genital investigations for chlamydia are particularly indicated in her case. Following the parallel of gonorrhoea, it seems that the use of contact tracers may be an effective method for controlling chlamydial infection.
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ranking = 2
keywords = conjunctivitis
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