Evaluation and treatment of unconventional genitourinary tract infections

It is fashionable to treat infections ascribed to unusual organisms, particularly in patients who don't improve following conventional antibacterial drug therapy. Unfortunately, all patients who meet this commonly used clinical definition are not infected with unusual organisms. Therefore, every effort should be made to actually identify a pathogen prior to initiating therapy. Specialized culture media or methods for direct identification of organisms in clinical specimens are necessary for accurate diagnosis. Fortunately, increased understanding of the microbiology of these organisms and improvement in diagnostic techniques should greatly improve the accuracy of clinical diagnosis. Precise diagnosis is important as a guide to specific therapy. In addition, many "unusual" infections are caused by organisms that are transmitted by sexual contact. The concept of sexually transmitted diseases is primarily clinical and not microbiologic in nature. The concept of sexually transmitted diseases represents a common mode of transmission for a wide variety of infectious diseases. The pathogens span the full spectrum of medical microbiology. From the biologic standpoint these organisms have few common characteristics aside from the ability to colonize and, on occasion, invade particular anatomic sites. Many sexually transmitted pathogens are fastidious organisms with exacting growth requirements. Such pathogens are susceptible to death in conditions outside of their usual habitat. Thus, diagnosis of many sexually transmitted pathogens requires both a high index of clinical suspicion and careful processing of clinical specimens. The concept of sexually transmitted diseases has important epidemiologic implications. Patients with one sexually transmitted disease are frequently infected with other sexually transmitted pathogens. Therefore, it is important to evaluate patients for multiple organisms transmitted by a similar mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)