A Young Man with Persistent Urethral Symptoms

Abstract

Pierre, a 23-year-old student, attends a Sexual Health clinic with a 5-day history of urethral discharge and mild pain on micturition. There are no other urological symptoms. He had been treated 1 month previously for non-gonococcal urethritis (NGU) with a single oral dose of 1 g of azithromycin. Within several days of that treatment, he became symptom free. He tolerated the medication well without vomiting or diarrhea. He has been in a regular sexual relationship for 3 months with a 19-year-old woman who attended the same clinic and was screened for sexually transmissible infections. As is routine clinic practice she was treated with azithromycin at that time. Neither Chlamydia trachomatis nor Neisseria gonorrhoeae was detected in either partner, and Trichomonas vaginalis was not identified in a saline-mount preparation of vaginal material. They abstained from sex for 1 week after treatment, but since then they have had regular unprotected vaginal intercourse. Neither partner has had sexual contact with another person for at least 4 months.