Etiology of urethritis in thai men

The etiology of urethritis was determined for 303 Thai men with urethral discharge containing 5 or more polymorphonu clear cells (PMN)/high power field (hpf) and 132 men with a discharge containing less than 5 PMN/hpf. Neisseria gonor- rhoeae was isolated significantly more often from men with ≥5 PMN/hpf than from men with <5 PMN/hpf (42% vs 1%, P <.0001). Chlamydia trachomatis was also isolated more often from patients with ≥5 PMN/hpf than from men with <5 PMN/hpf (16% vs 8%, P <.03). Ureaplasma urealyticum was isolated with nearly equal frequency from both groups of pa tients (45% vs 37%).Among men with a urethral exudate containing ≥5 PMN/ hpf, N. gonorrhoeae was isolated as the only pathogen from 19% and in combination with C. trachomatis or U. urealyticum in 23% of these men. C. trachomatis or U. urealyticum, but not N. gonorrhoeae, was isolated from 30%, and no pathogen was isolated from 28% of these men. Among men with urethral exudate containing less than 5 PMN/hpf, N. gonorrhoeae was isolated from only 1%, C. trachomatis or U. urealyticum from 41%, and no pathogen from 58%. These findings suggest that all Thai men with urethral discharge containing ≥5 PMN/hpf should be treated for non-gonococcal urethritis and for gono coccal urethritis if gram-negative diplococci are demonstrated on gram stain of the urethral discharge. Men with urethritis with less than 5 PMN/hpf should be treated for only non gonococcal urethritis.