Sexually transmitted pathogens causing urethritis: A mini-review and proposal of a clinically based diagnostic and therapeutic algorithm

Abstract

The purpose of this mini-review was to provide the latest information and concepts on diagnosis and treatment of the most common sexually transmitted pathogens causing urethritis. The incidence of several sexually transmitted infections that cause urethritis is increasing, and this genitourinary syndrome is among the most common reason young men see clinical care. The authors performed a literature search including the currently valid guidelines, and an overview of the most relevant pathogens is given. Moreover, the authors developed a clinically applicable diagnostic and therapeutic algorithm, because early diagnosis and correct treatment can sometimes prevent infected individuals from significant morbidity. Future research will focus on new methods to combat pathogens that cause urethritis, including vaccination.

Keywords: Adenovirus; Chlamydia trachomatis; Mycoplasma genitalium; Neisseria gonorrhoeae (NG); sexuall transmitted infections; urethritis.

FIGURE 1

Recommended diagnostic and therapeutic algorithm in case of urethritis or risk of urethral STI. AD, Adenovirus; BID, bis in die (twice a day); CDC, center of disease control and prevention; CT, Chlamydia trachomatis; HBV, hepatitis B virus; HCV, hepatitis C virus; HI, Haemophilus influenzae; HIV, human immunodeficiency virus; HSV1, herpes simplex virus 1; HSV2, herpes simplex virus 2; i.m., intramuscular; IUSTI, European section of the international union against sexually transmitted infections; i.v., intravenous; MG, Mycoplasma genitalium; MH, Mycoplasma hominis; MP, Mycoplasma penetrans; NAATs, nucleic acid amplification tests; NG, Neisseria gonorrhoeae; PMNLs, polymorphonuclear leukocytes; p.o., per os; TOC, test of cure; TV, Trichomonas vaginalis; UP, Ureaplasma parvum; UU, Ureaplasma urealyticum.