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P794 Signs and symptoms associated with single-pathogen nongonococcal urethritis in men
  1. Teresa Batteiger1,
  2. Stephen Jordan2,
  3. Evelyn Toh3,
  4. James Williams2,
  5. Lora Fortenberry3,
  6. Byron Batteiger1,
  7. David Nelson3
  1. 1Indiana University School of Medicine, Medicine, Division of Infectious Diseases, Indianapolis, USA
  2. 2Indiana University School of Medicine, Infectious Diseases, Indianapolis, USA
  3. 3Indiana University School of Medicine, Microbiology and Immunology, Indianapolis, USA


Background Syndromic management remains the standard nongonococcal urethritis (NGU) treatment approach. Whether pathogen-specific signs/symptoms inform treatment decisions remains unclear. We identified men with single- and mixed-pathogen NGU and assessed for the presence of pathogen-specific signs or symptoms to improve syndromic management.

Methods As part of an ongoing cohort study (the Idiopathic Urethritis Men’s Project [IUMP]), we recruited men with NGU. NGU was diagnosed by signs and/or symptoms of urethritis, and a urethral Gram stain with 5 neutrophils per high-power field without evidence of gram negative intracellular diplococci. Participants underwent a clinical history and physical exam, which documented specific self-reported symptoms and clinician observed signs. Single- and mixed-infections were identified by NAAT testing of first-catch urine for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Trichomonas vaginalis (TV), and Ureaplasma urealyticum (UU); five-pathogen-negative cases were classified as idiopathic urethritis (IU).

Results One hundred fifty-five men with NGU are included in this analysis. The median age was 28 (range 18–63), 101 (65%) were African American, and 135 (87%) self-identified as heterosexual. The most commonly reported symptom was urethral discharge (92%), followed by burning/tingling (37%), and dysuria (28%). Over half of these men reported more than one symptom (58%). Single-pathogen NGU was detected in 99 (64%) men, mixed-pathogen in 14 (9%), and IU in 42 (27%). For single pathogen NGU, 53 (34%) had CT, 26 (17%) had MG, 3 (2%) had TV, and 17 (11%) had UU. We compared single-pathogen NGU, mixed-infection and IU for differences in signs or symptoms and found no pathogen-specific differences.

Conclusion In men with NGU, no pathogen-specific signs and symptoms were identified that could inform treatment decisions. Pathogen-specific point-of-care tests are needed.

Disclosure No significant relationships.

  • urethritis

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