Etiological study of male urethritis in Medellín, Colombia

Abstract

In order to further advance etiological knowledge on male urethritis in Medellín. Colombia, we studied 100 patients who attended a Public Health Laboratory for diagnostic purposes; direct immunofluorescent or ELISA tests were performed for Chlamydia trachomatis and Gram stain and selective cultures for the search of Neisseria gonorrhoeae. β lactamase production was determined for the strains of N. gonorrhoeae. Cultures were done for other aerobic bacteria and direct tests carried out for Trichomonas vaginalls and Candida spp. Chlamydia trachomatis was the sole agent in 22 patients and was associated with other agents In 11 more (including 6 patients wlth the association Chlamydia + Neisseria). Ten patients were Infected only with Neisseria gonorrhoeae, six with a haemolytic streptococci, four with Candida spp and two with Trichomonas vaginalis. Etiology remained unknown In 45 patients. Fifteen of the 16 strains of Neisseria gonorrhoeae were tested for β lactamase production and 10 resulted positive (66.7%). Urethral discharge was mucoid In the 22 patients Infected only with C. trachomatis while 9 of 10 with gonorrhea had purulent discharge. Leucocytic reaction of the discharge was above 10 per high power field In 8 of 10 patients with gonococcal urethritis and In 4 of 6 with mixed ( Chlamydia + Neisseria) infection; by contrast only 6 of 22 patients with pure Chlamydia infection had such degree of Inflammation. Dysuria was present In every patient. Future studies should evaluate the etiological role of other agents In male urethritis and pursue the determination of the frequency of β lactamase production. In view of our findings penicillin therapy is presently not recommended for gonorrhea In Medellín.