Nongonococcal Urethritis and Chlamydial Cervicitis

Nongonococcal urethritis and chlamydial cervicitis are sexually transmitted diseases caused by the bacterium Chlamydia trachomatis and various other microorganisms that produce inflammation of the urethra and cervix.

Several different microorganisms cause diseases that resemble gonorrhea. These microorganisms include Chlamydia trachomatis, Trichomonas vaginalis, and several different types of Mycoplasma. In the past, these microorganisms were hard for laboratories to identify, so the infections they caused were simply called “nongonococcal” to indicate that they were not caused by Neisseria gonorrhoeae, the bacterium that causes gonorrhea.

Chlamydia trachomatis infection (chlamydia) is very common, with 659,000 reported cases in the United States in 1999. Because the infection sometimes produces no symptoms, even more people may be affected. In men, chlamydia causes about half of the
urethral infections not caused by gonorrhea. Most of the remaining male urethral infections are caused by Ureaplasma urealyticum. In women, chlamydia accounts for virtually all of the pus-forming cervical infections not caused by gonorrhea. Both sexes may acquire gonorrhea and chlamydia at the same time.

Many women remain symptom-free. if symptoms do occur, they may include:
·abnormal vaginal discharge.
·frequent urge to urinate.
·pain in the lower abdomen.
·pain on deep penetration during sex.

If left untreated, chlamydial cervicitis can sometimes lead to pelvic inflammatory disease, which is a major cause of infertility in women. If the infection enters the bloodstream, the disorder may lead to a form of arthritis.

Between 4 and 28 days after intercourse with an infected person, an infected man typically has a mild burning sensation in his urethra while urinating. A clear or cloudy discharge from the penis may be evident. The discharge is usually less thick than the discharge that occurs in gonorrhea. Early in the morning, the opening of the penis is often red and stuck together with dried secretions. Occasionally, the disease begins more dramatically. The man needs to urinate frequently, finds urinating painful, and has discharge of pus from the urethra.

Although most women infected with Chlamydia have few or no symptoms, some experience frequent urges to urinate and pain while urinating, pain in the lower abdomen, pain during sexual intercourse, and secretions of yellow mucus and pus from the vagina.
Anal infections may cause pain and a yellow discharge of pus and mucus.


In most cases, a doctor can diagnose chlamydia by examining discharge from the penis or cervix in a laboratory. Newer tests that amplify DNA or RNA, such as the polymerase chain reaction (PCR), enable a doctor to diagnose chlamydia or gonorrhea from a urine sample. These tests are recommended for screening of sexually active women between the ages of 15 and 25. Genital infections with Ureaplasma and Mycoplasma are not diagnosed specifically in routine medical settings, because culturing of these microorganisms is difficult and other techniques for diagnosis are expensive. The diagnosis of nongonococcal infections is often presumed if the person has characteristic symptoms and no evidence of gonorrhea.

If chlamydia is not treated, symptoms usually disappear in 4 weeks. However, an untreated infection can cause a number of complications. Untreated chlamydial cervicitis often ascends to the fallopian tubes (tubes that connect the ovaries to the uterus), where inflammation may cause pain and scarring. The scarring can cause infertility and ectopic pregnancy (see Pregnancy at High-Risk :Risk Factors That Develop During Pregnancy). These complications can occur in women without symptoms and result in considerable suffering and medical costs. In men, chlamydia may cause epididymitis, which produces painful swelling of the scrotum on one or both sides (see Penile and Testicular Disorders: Epididymitis and Epididymo-orchitis).

Whether Ureaplasma has a role in these complications is unclear.


Chlamydial and ureaplasmal infections are usually treated with tetracyclineSome Trade Names
, doxycyclineSome Trade Names
, or levofloxacinSome Trade Names
taken by mouth for at least 7 days or with a single dose of azithromycinSome Trade Names
taken by mouth. Because the symptoms are so similar to those of gonorrhea, doctors usually give an antibiotic such as

ceftriaxoneSome Trade Names
to treat gonorrhea at the same time. Pregnant women are given erythromycinSome Trade Names
instead of tetracyclineSome Trade Names
or doxycyclineSome Trade Names
. If symptoms persist or return, treatment is then repeated for a longer period.

Complications of Chlamydial and Ureaplasmal Infections :

In men

Infection of the epididymis
Narrowing (stricture) of the urethra
In women

Infection of the fallopian tubes and linings of the pelvic cavity
Infection of the surface of the liver
In men and women

Infection of the membranes of the eyes (conjunctivitis)
In newborns


Prevention & Precautions:

Infected people who have sexual intercourse before completing treatment may infect their partners. Also, partners who are infected may re-infect the treated person. Thus, sex partners are treated simultaneously if possible. The risk of a repeat infection of chlamydia or another STD within 3 to 4 months is high enough that screening may be repeated at that time.

Click to learn more about Chlamydia infection
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.


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