This disease refers to a urogenital tract infection characterized by clinical manifestations of urethritis, but with no detection of Neisseria gonorrhoeae in smear or culture tests of secretions. Since female patients not only exhibit urethritis but may also have cervicitis, it is also referred to as "non-specific genital infection" (NSGI). It is primarily caused by infection with Chlamydia trachomatis or Ureaplasma urealyticum, and in rare cases, may also be triggered by Trichomonas vaginalis, Candida albicans, or herpes simplex virus, among others. It is one of the common sexually transmitted diseases.

bubble_chart Diagnosis

1. History of extramarital sexual contact or spouse infection, with an incubation period of 1 to 3 weeks.

2. Clinical manifestations: Men often experience itching, burning, or stabbing pain in the urethra, sometimes with urgency and dysuria. However, symptoms are generally milder than those of gonorrhea. The urethral orifice may show congestion or redness, with serous, mucopurulent, or thin white discharge, or a "sealing" phenomenon upon waking. Women with urethritis may present with frequency, urgency, or dysuria; cervicitis may manifest as increased leucorrhea, cervical congestion, redness, or erosion; and symptoms such as vaginal and vulvar cutaneous pruritus may occur. Many patients, especially women, may have no symptoms or only mild symptoms.

3. The disease can be transmitted through the birth canal, causing neonatal conjunctivitis, pneumonia, rhinitis, otitis media, and vaginitis in female infants.

4. Complications: The main complications in men include epididymitis, prostatitis, and Reiter's syndrome; in women, they include salpingitis, pelvic inflammation, ectopic pregnancy, and infertility.

(1) Both smear and culture for gonococci are negative. However, microscopic examination under oil immersion (1000x) showing more than 4 polymorphonuclear leukocytes per field, or examination of 15 mL of first-void morning urine sediment under high power (400x) showing more than 15 polymorphonuclear leukocytes per field, is diagnostically significant.

(2) If conditions permit, etiological tests for pathogens such as Chlamydia trachomatis and Ureaplasma urealyticum can be performed.

bubble_chart Treatment Measures

1. Tetracycline 500 mg, orally 4 times daily, for at least 7 days, generally 2 to 3 weeks. Alternatively, after 7 days, reduce to 250 mg, 4 times daily, until 21 days.

2. Doxycycline 100 mg, orally twice daily, for 7 to 14 days.

3. Minocycline 100 mg, orally twice daily, for 7 to 14 days.

4. Oxytetracycline 250 mg, orally 4 times daily, for 7 to 14 days.

5. Ofloxacin 200 mg, orally 2 to 3 times daily, for 7 to 14 days.

6. Roxithromycin 150 mg, orally twice daily, for 7 days.

7. Azithromycin 1 g administered at draught.

8. Erythromycin 500 mg, orally 4 times daily, for 7 days. For neonatal conjunctivitis or pneumonia, 50 mg/kg daily, divided into 4 doses, for 10 to 14 days. For children weighing >45 kg, follow adult dose; for those <45 kg, 50 mg/kg daily, divided into 4 doses, for 10 to 14 days.

9. Chinese medicinals: Double Coptis Rhizome powder injection 60 mg/kg daily, added to 500 mL of normal saline for intravenous drip, once daily, for 10 days.

bubble_chart Differentiation

The disease should primarily be differentiated from gonococcal urethritis. The latter has a shorter incubation period, averaging 3 to 5 days, with more severe dysuria and purulent discharge that is copious. Gonococcal tests are positive. In contrast, NGU discharge is usually serous or mucopurulent, thinner, and scant, with no gonococci detected.