Cases reported "Urethritis"

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21/85. 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. ( info)

22/85. Chlamydial seminal vesiculitis without symptomatic urethritis and epididymitis.

    We previously reported that seminal vesiculitis was associated with acute epididymitis, and that chlamydia trachomatis was the major causative pathogen for infection of the seminal vesicle, suggesting that seminal vesiculitis was a discrete disease entity. In this paper, we report two patients with bacteriologically and cytologically proven seminal vesiculitis who had asymptomatic urethritis but not epididymitis. The clinical courses of these patients suggest that chlamydial seminal vesiculitis may be a cause of asymptomatic infection of the urethra or subsequent development of acute epididymitis. ( info)

23/85. 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. ( info)

24/85. neisseria meningitidis in specimens from urogenital sites. Is increased awareness necessary?

    neisseria meningitidis serogroups B type 2 and Y were isolated from urogenital specimens from three heterosexual patients. The first patient was a young man with the clinical signs and microscopic findings of a typical gonococcal urethritis. The second was a middle-aged woman with cervicitis, in whom neither neisseria gonorrhoeae nor chlamydia trachomatis were demonstrated by culture. In the third patient, a young woman, N. meningitidis was associated with cervicitis, acute salpingitis, and peritonitis. The patients' clinical symptoms responded quickly to antibiotic treatment. Meningococci of the same serogroup/serotype as the index cases were demonstrated in two of the sexual consorts in pharyngeal specimens but not in genitourinary specimens. Orogenital sexual practice seemed to be the most likely route of transmission. During the period of this study (August 1989-March 1990), the three meningococcal strains observed at the authors' laboratory represented 20% of the total number of urogenital isolates of pathogenic Neisseria. A greater awareness of this problem from medical, diagnostic, epidemiologic, and legal viewpoints is therefore needed. ( info)

25/85. urethritis caused by neisseria meningitidis: a case report.

    Isolation of N. meningitidis from the male urethra has become more common in recent years and this has been attributed to sexual activities and changes in social attitudes. We describe a further case of acute urethritis caused by transmission of N. meningitidis occurring after a single sexual contact (fellatio) in a heterosexual man. The urethritis was initially diagnosed as being caused by N. gonorrhoeae on a presumptive basis, then attributed to N. meningitidis serogroup Y. This case shows the need of accurate diagnostic procedures in all cases resembling gonococcal urethritis. ( info)

26/85. Drug induced suicidal ideation.

    The authors present a case study of a mentally healthy man who repeatedly experienced short-lived, obsessional-like suicidal ideas and images after ingestion of the anti-fungal drug ketoconazole. ego-alien, suicidal ideas are an extremely rare form of adverse drug reaction. This is probably the first report of drug-induced ego-dystonic, mood incongruent suicidal ideas appearing in a fully conscious, healthy individual. ( info)

27/85. haemophilus parainfluenzae causing sexually transmitted urethritis. Report of a case and evidence for a beta-lactamase plasmid mobilizable to escherichia coli by an Inc-W plasmid.

    A multiple antibiotic resistance, beta-lactamase-producing strain of Haemophilus parainfluenzae was isolated from a patient with sexually transmitted urethritis that was contracted in Northwest africa. The strain was found to harbor a small (3.2 megadaltons) plasmid encoding for beta-lactamase production, which was successfully mobilized to escherichia coli in triparental mating experiments by means of a broad host-range Inc-W conjugative plasmid. Since H. parainfluenzae is believed to be a source and reservoir for the spread of beta-lactamase plasmids to other bacterial species, such a plasmid mobilization may suggest a new possible means for resistance plasmid dissemination. ( info)

28/85. Meningococcal urethritis.

    Two to four percent of the population carry meningococcus in the nasopharynx. Pharyngeal infections may be the entry point for blood-borne metastatic lesions throughout the body. Primary infections in other tissues are rare, and proof of transmission from a known carrier to a specific patient is uncommon. We report a primary infection of the urethra with the meningococcus in a heterosexual male contracted during an act of fellatio. ( info)

29/85. Partial characterization of chlamydia trachomatis isolates resistant to multiple antibiotics.

    in vitro susceptibility testing was done on urogenital isolates of chlamydia trachomatis from five patients, four of whom were suspected treatment failures. At least one isolate from each patient was resistant to tetracycline at concentrations greater than or equal to micrograms/ml, although less than 1% of a population of organisms showed high-level resistance. Fully resistant populations selected by passage through 8 micrograms/ml tetracycline either died or lost their resistance on further passage in antibiotic-free medium. Relatively large inocula were required to demonstrate resistance, and morphology of inclusions was altered at high tetracycline concentrations. The observed resistance may be a new characteristic of the organism or merely newly recognized. Isolates resistant to tetracycline were resistant to doxycycline, erythromycin, sulfamethoxazole, and clindamycin but sensitive to rifampin, ciprofloxacin, and ofloxacin. Thus, resistance to tetracycline, erythromycin, and clindamycin occurs in C. trachomatis and may be a factor in some treatment failures. ( info)

30/85. Acute urethritis due to neisseria meningitidis group A acquired by orogenital contact: case report.

    A case of heterosexual transmission of neisseria meningitidis group A by fellatio, which resulted in acute purulent urethritis in the male partner, is presented. The emotional impact of a mistaken diagnosis of gonococcal infection and the need to treat asymptomatic throat carriage in sexual contacts makes early recognition of meningococcal infection important in this unusual circumstance. ( info)
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