NORMAN F. JACOBS Jr., M.D.; STEPHEN J. KRAUS, M.D.
The clinical and laboratory features of urethritis were studied in 400 symptomatic men at a venereal disease clinic. Most patients (54%) had nongonococcal urethritis; only 46% had gonococcal urethritis. In 85% of the cases, the Gram stain was read as unequivocally positive or negative; its accuracy in these cases was 98%. In 15% of the Gram stains, rare typical extracellular Gram-negative diplococci were intermingled with many atypical pleomorphic Gram-negative diplococci; in these cases cultures were essential for diagnosis. Patients with gonococcal urethritis usually had symptoms of both dysuria and discharge of short duration; patients with nongonococcal urethritis had variable symptoms of longer duration (P < 0.0005). Spontaneous purulent discharge was found only in patients with gonococcal urethritis. Most patients with nongonococcal urethritis had no discharge or mucoid discharge obtained only after penile stripping. These findings provide a basis for the rapid differential diagnosis of urethritis, which will permit immediate, definitive treatment for most men with urethritis.
JACOBS NF, KRAUS SJ. Gonococcal and Nongonococcal Urethritis in Men: Clinical and Laboratory Differentiation. Ann Intern Med. ;82:7–12. doi: 10.7326/0003-4819-82-1-7
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Published: Ann Intern Med. 1975;82(1):7-12.
Infectious Disease, Nephrology, Sexually Transmitted Infections, Urological Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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