Page 275 - Learnwell EVS
P. 275
9. Genito-urinary diseases
Urethral discharge
U reth ral d isch arg e is seen alm ost exclusiv ely in m en. T h e principal causativ e org anism s
are Neisseria gonorrhoeae (g onorrh oea) and Chlamydia trachomatis (ch lam yd ia).
T h e presence of abnorm al d isch arg e sh ould be confirm ed by perform ing a clinical
exam ination1. In m ales, th e ureth ra sh ould be m ilked g ently if no d isch arg e is v isible.
Furth erm ore, specifically ch eck for ureth ral d isch arg e in patients com plaining of
painful or d ifficult urination (d ysuria).
Case management
T h e patient com plains
of ureth ral d isch arg e
or d ysuria
T ake h istory
and exam ine
U reth ral d isch arg e is N O Anoth er g enital N O Reassess th e patient
present? cond ition is present? if sym ptom s persist
YE S YE S 9
Treat for gonorrhoea Ad m inister
AND appropriate treatm ent
chlamydia
Laboratory
– C. trachomatis cannot easily be id entified in a field laboratory. In th e absence of
v alid ated rapid d iag nostic tests, th e treatm ent is em piric.
– In m en, a m eth ylene blue or Gram stained sm ear from a ureth ral swab m ay be used
to d etect g onococci (Gram neg ativ e intracellular d iplococci).
1 In areas where lymphatic filariasis is endemic, be careful not to confuse purulent urethral discharge with milky or
rice-water urine (chyluria) suggestive of lymphatic filariasis.
231
Urethral discharge
U reth ral d isch arg e is seen alm ost exclusiv ely in m en. T h e principal causativ e org anism s
are Neisseria gonorrhoeae (g onorrh oea) and Chlamydia trachomatis (ch lam yd ia).
T h e presence of abnorm al d isch arg e sh ould be confirm ed by perform ing a clinical
exam ination1. In m ales, th e ureth ra sh ould be m ilked g ently if no d isch arg e is v isible.
Furth erm ore, specifically ch eck for ureth ral d isch arg e in patients com plaining of
painful or d ifficult urination (d ysuria).
Case management
T h e patient com plains
of ureth ral d isch arg e
or d ysuria
T ake h istory
and exam ine
U reth ral d isch arg e is N O Anoth er g enital N O Reassess th e patient
present? cond ition is present? if sym ptom s persist
YE S YE S 9
Treat for gonorrhoea Ad m inister
AND appropriate treatm ent
chlamydia
Laboratory
– C. trachomatis cannot easily be id entified in a field laboratory. In th e absence of
v alid ated rapid d iag nostic tests, th e treatm ent is em piric.
– In m en, a m eth ylene blue or Gram stained sm ear from a ureth ral swab m ay be used
to d etect g onococci (Gram neg ativ e intracellular d iplococci).
1 In areas where lymphatic filariasis is endemic, be careful not to confuse purulent urethral discharge with milky or
rice-water urine (chyluria) suggestive of lymphatic filariasis.
231
