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 Non specific genital infection

Other names

Non-specific urethritis (NSU), nongonococcal urethritis (NGU), non-specific cervicitis, chlamydial infection.

Causes

Nonspecific genital infection is an infection of the urethra or cervix (in the female) where a cause cannot be demonstrated on routine investigations. With  special investigations, however, the causes identified include:-

  • Chlamydia trachomatis 30 -50%
  • Ureaplasma urealyticum 10 - 40%
  • Others 20 -30%

- Trichomoniasis
- Candidiasis
- Wart, herpes or primary syphilis of the urethra
- Foreign body in the urethra
- Urethral stricture or narrowing
- Allergy
- Unknown (true NSU/NSGI)

Distribution

Worldwide

Tansmission

  • Sexual in most cases.
  • Mother to child, usually during delivery.

Incubation

1 - 4 weeks.

Symptoms

Infection in men usually developes in the urethra causing a urethritis. Hence, infection is commonly known as nonspecific urethritis (NSU) or nongonococcal  urethritis (NGU). In women, infection usually occurs in the  cervix and is called nonspecific cervicitis or just nonspecific genital infection (NSGI).

NSU/NGU
- Burning or itching during urination.
- Milky discharge, particularly noticeable in the morning.
- Stains on the underwear.
- No symptoms.

NSGI/Nonspecific cervicitis
- Itching and burning of the vagina
- Slight vaginal discharge.
-No symptoms (the majority).
NB  These symptoms are often not characteristic so NSGI is often made on the basis of the male partner  having NSU.

Diagnosis

  • Microscopic examination of secretions for pus.
  • Excluding gonorrhoea which causes similar symptoms.
  • Where available, culture tests for Chlamydia trachomatis and Ureapalsma urealyticum.

Treatment

Antibiotics by mouth (penicillin and antibiotic injections are ineffective).

Complications

    In men,
  • Recurrent or chronic NSU
  • Reiters disease
    Symptoms:
    - Arthritis (joint inflammation).
    - Conjunctivitis (eye inflammation).
    - Rashes.
  • Epididymitis - This is an inflammation of the epididymis of storehouse for sperm. It may cause infertility.
    Symptoms:
    - Pain and swelling of the testis.
     
    In women,
  • Pelvic inflammatory disease (PID) - This is caused by infection spreading into the uterus and Fallopian tubes. PID may result in infertility.
    Symptoms:
    - Lower abdominal pain.
    - Backache
    - Menstrual irregularities.
    - Low-grade fever.

    In the newborn,
  • Neonatal (newborn) conjuctivitis - Eye infection caused by infected vaginal secretions contaminating the babys eyes. Chlamydia trachomatis is  usually the cause.
  • Neonatal (newborn pneumonia) - Lung infection caused by inhalation or ingestion of infected vagina secretions during delivery. Chlamydia  trachomatis is the cause.

Comments

NSGI and gonorrhoea may occur together. However, gonorrhoea has a shorter incubation period so its symptoms appear first. The symptoms of NSU, on the other hand appear 1 -2 weeks later, by  which time gonorrhoea would have been treated and cleared. NSU occuring after gonorrhoea is termed postgonococcal urethritis (PGU).