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Urinary Tract Infection in a Small Animal Model: Transurethral Catheterization of Male and Female Mice
Published on: December 1, 2017
Streptococcus urinalis: A potential case of male urethritis caused by a novel pathogen
Jorge Ligero-López1, Antonio Beltrán-Rosel1,2,3, María Ducóns-Márquez4
1Clinical Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
Abstract:
Urethritis is a frequent lower urinary tract infection often linked to sexually transmitted infections (STIs). While Neisseria gonorrhoeae and Chlamydia trachomatis are the main pathogens, other microorganisms such as Mycoplasma genitalium, Trichomonas vaginalis, and Ureaplasma urealyticum may also be involved. In over half of non-gonococcal urethritis (NGU) cases, no causative agent is identified. We present the case of a 37-year-old man with scrotal pain, painful ejaculation, dysuria, and urethral discharge following a single unprotected sexual encounter. Initial STI PCR was positive for Ureaplasma urealyticum, and azithromycin was prescribed. Symptoms persisted, and a urethral culture revealed Streptococcus urinalis, confirmed by MALDI-TOF MS and 16S rRNA sequencing. Gram staining showed numerous leukocytes and Gram-positive cocci in chains. A second urethral swab yielded the same organism. The isolate was fully susceptible to all tested antibiotics. Although S. urinalis has been described in urinary tract infections and sepsis, to our knowledge, this is the first reported case suggesting a possible role in male urethritis. While prostatitis or epididymitis cannot be ruled out, the repeated isolation of S. urinalis and persistent symptoms support its potential pathogenicity. This case adds to growing evidence implicating S. urinalis in genitourinary tract infections.
Insights
This case study identifies Streptococcus urinalis as a potential cause of persistent urethritis in men, even after initial treatment for common STIs. Further research is needed to confirm its role in genitourinary infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Urology
Background:
- Urethritis is a common lower urinary tract infection, frequently associated with sexually transmitted infections (STIs).
- Neisseria gonorrhoeae and Chlamydia trachomatis are primary pathogens, but other microorganisms like Ureaplasma urealyticum can also be involved.
- A significant proportion of non-gonococcal urethritis (NGU) cases remain idiopathic, lacking an identified causative agent.
Purpose of the Study:
- To report a case of male urethritis potentially caused by Streptococcus urinalis.
- To highlight the diagnostic challenges in identifying uncommon pathogens in urethritis.
Main Methods:
- Clinical presentation of a 37-year-old male with urethritis symptoms after unprotected sexual contact.
- Initial STI PCR positive for Ureaplasma urealyticum, treated with azithromycin.
- Persistent symptoms led to urethral culture, MALDI-TOF MS, and 16S rRNA sequencing confirming Streptococcus urinalis.
Main Results:
- Ureaplasma urealyticum was initially identified and treated, but symptoms persisted.
- Repeated urethral sampling consistently isolated Streptococcus urinalis.
- The Streptococcus urinalis isolate was susceptible to all tested antibiotics.
Conclusions:
- This is the first reported case suggesting Streptococcus urinalis as a potential pathogen in male urethritis.
- Persistent symptoms and repeated isolation support the pathogenicity of S. urinalis in this genitourinary infection.
- This case contributes to emerging evidence of S. urinalis in genitourinary tract infections.
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