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Nonspecific Genitourinary Infections

Nonspecific genitourinary infections, which include nongonococcal urethritis in males and mild vaginitis or cervicitis in females, have similar manifestations. Nonspecific genitourinary infections have become more prevalent since the mid 1960s and are more widespread than gonorrhea. The prognosis is good if sexual partners are treated simultaneously.

Causes

Nonspecific genitourinary infections are spread primarily through sexual intercourse. Incidents involving a motor vehicle(s) are the most common cause of genitourinary system injury, and are responsible for one-half to two-thirds of all genitourinary system injuries. Other causes such as sport related incidents and assaults account for the balance of genitourinary system injuries. In children, problems of the urinary system include acute and chronic kidney failure, urinary tract infections, obstructions along the urinary tract, and abnormalities present at birth.

Although less is known about nonspecific genitourinary infections in females, in women, genital infections may cause a vaginal discharge, mucosal ulceration producing local discomfort and pain on intercourse, or pelvic inflammatory disease. A thin vaginal epithelium may predispose prepubertal and post­menopausal females to nonspecific vaginitis.

Signs and Symptoms

  • fever
  • shock
  • nausea
  • vomiting
  • internal bleeding
  • evidence of physical injury
  • Blood in the urine
  • severe pain in the flank
  • severe pain in lower back
  • swelling of the abdomen

Diagnostic tests

In males, smears of prostatic or urethral secretions show excessive polymorphonuclear leukocytes but few, if any, specific organisms.

In females, cervical or urethral smears show similar results.

Epithelial cells covered with bacteria confirm infection.

Treatment

Therapy for both sexes consists of 500 mg of oral metronidazole twice a day for 7 days or a single 2-g dose. For females, treatments may also include application of a vaginal cream and, occasionally, cryosurgery.



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