II. Causes

  1. See Dysuria (Urethritis)
  2. Chlamydia trachomatis (35-45%)
  3. Mycoplasma Genitalium (30%)
  4. Trichomonas vaginalis (13%)
  5. Ureaplasma urealyticum or Ureaplasma parvum
    1. Unclear if Ureaplasma causes Urethritis
  6. Herpes Simplex Virus

III. Symptoms

  1. Urethral discharge
  2. Dysuria

IV. Differential Diagnosis

V. Labs

  1. See Sexually Transmitted Infection
  2. Gonorrhea PCR
  3. Chlamydia PCR
  4. Trichomonas PCR or Wet Prep
  5. Mycoplasma Genitalium NAAT may be available (esp for persistent or recurrent symptoms)

VI. Management

  1. Precaution
    1. See Dysuria for a more complete protocol for evaluation and management
    2. Also give Ceftriaxone 500 mg IM/IV for 1 dose (1 gram IM/IV if weight > 150 kg) if Gonorrhea not excluded
  2. First-Line (empiric for Chlamydia AND Trichomonas)
    1. Azithromycin 1 gram for one dose AND
    2. Metronidazole 2 grams for one dose
  3. Alternative regimen
    1. Doxycycline 100 mg orally twice daily for 7 days AND
    2. Tinidazole 2 grams for one dose
  4. Persistent Urethritis
    1. See Dysuria
    2. Consider resistant Mycoplasma Genitalium
      1. See Mycoplasma Genitalium for treatment regimen
      2. Consider Moxifloxacin 400 mg orally daily for 10 days

VII. Resources

  1. Non-Gonococcal Urethritis (Stat Pearls)
    1. https://www.ncbi.nlm.nih.gov/books/NBK535411/

VIII. References

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Related Studies

Ontology: non-gonococcal urethritis (NGU) (C1112709)

Concepts Disease or Syndrome (T047)
ICD10 N34.1
SnomedCT 84619001
English NGU - Non-GC urethritis, NSGI - Nonspec genit infectn, NGU (nongonococcal urethritis), nongonococcal urethritis, nongonococcal urethritis (diagnosis), Non-gonococcal urethritis, Unspecified nongonococcal urethritis (NGU), Unspecified non-gonococcal urethritis (NGU), NGU - Non-gonococcal urethritis, Nonspecific urethritis, Nonspecific genital infection, NSGI - Nonspecific genital infection, Urethritis-non-specific, NSU - Nonspecific urethritis, NGU, Nongonococcal urethritis, Nongonococcal urethritis (disorder), urethritis; nongonococcal, NGU, NOS, Nongonococcal urethritis, NOS, Nonspecific urethritis, NOS, Non-Gonococcal Urethritis, non-gonococcal urethritis (NGU)
Dutch niet-gonokokkenuretritis, niet-gespecificeerde non-gonokokkenurethritis (NGU), non-gonokokkenurethritis, niet-gespecificeerde niet-gonokokkenuretritis (NGU), urethritis; niet door gonokokken, Niet-specifieke urethritis
French UNG (urétrite non gonococcique), Urétrite non gonococcique, Urétrite non gonococcique non précisée
German NGU, unspezifische nicht von Gonokokken verursachte Urethritis (NGU), nicht von Gonokokken verursachte Urethritis, Unspezifische Urethritis
Italian Uretrite non gonococcica, Uretrite non gonococcica non specificata
Portuguese Uretrite não gonocócica NE, Uretrite não gonocócica
Spanish Uretritis no-gonocócica indeterminada, Uretritis no gonocócica, Uretritis no gonocócica no especificada (UNG), UNG, uretritis no específica, uretritis no gonocócica (trastorno), uretritis no gonocócica
Japanese 詳細不明の非淋菌性尿道炎, 非淋菌性尿道炎, ショウサイフメイノヒリンキンセイニョウドウエン, ヒリンキンセイニョウドウエン
Czech Negonokoková uretritis, Negonokoková uretritida, Blíže neurčená negonokoková uretritida, Blíže neurčená negonokoková uretritis
Korean 비특이성 요도염
Hungarian Nem-gonococcalis urethritis, Non-gonococcalis nem meghatározott urethritis (NGU), Non-gonococcalis urethritis, Nem-gonococcalis nem meghatározott urethritis (NGU), NGU