Nongonococcal urethritis: a survey of clinical and laboratory features

The clinical and laboratory features of nongonococcal urethritis were studied in 96 patients. Data from previous episodes of urethritis were obtained from 88 men; histories of previous urethritis were obtained from 46 (52%) of the 88 men. Prostatic enlargement (and often tenderness) was found on rectal examination of 22 men (23%) and correlated with a history of previous episodes(s) of urethritis (P less than 0.01). Chlamydia trachomatis was recovered from 19 patients (20%), Ureaplasma urealyticum from 58 (60%), and neither organism from 27 (28%). Results of serologic test for C. trachomatis correlated with cultural findings and demonstrated a high prevalence of preexisting antibody. In comparison with those patients whose urethral smears showed greater purulence, patients with five or fewer polymorphonuclear leukocytes (per 1,000 x field) on the urethral smear had similar frequencies of recovery of C. trachomatis, prostatic abnormalities, and responses to therapy, but had lower frequencies of urethral discharge and recovery of U. urealyticum. A 14-day course of either tetracycline hydrochloride or doxycycline hyclate was successful in eradicating both symptoms and pathogens, except for cases for cases in which initial isolates of U. urealyticum showed in-vitro resistance.