Microbiology of acute epididymitis in a developing community.
OBJECTIVE
To investigate the aetiology of acute epididymitis in a developing community with a view of determining appropriate antimicrobial therapy.


METHODS
City Health Sexually Transmitted Diseases Clinic, King Edward VIII Hospital, Durban, South Africa.


METHODS
144 adult men with clinically diagnosed acute epididymitis.


METHODS
Endourethral swab and midstream urine (MSU) specimens were processed to detect sexually transmitted pathogens and urinary tract infections.


RESULTS
The majority of patients (93%) were less than 35 years of age. Neisseria gonorrhoeae and/or Chlamydia trachomatis were detected in 78% of patients: N gonorrhoeae in 57%, C trachomatis in 34% and both in 13%. Escherichia coli was cultured more frequently from MSU specimens of older patients, 30% versus 3%. In 53% of patients urethritis was diagnosed by the presence of inflammatory cells in endourethral smears in the absence of a visible urethral discharge.


CONCLUSIONS
In our setting of a busy clinic with limited facilities, we recommend the performance of a Gram stain on endourethral specimens from patients with acute epididymitis. If inflammatory cells and Gram negative diplococci are detected, treatment with antimicrobial agents to cover both penicillinase-producing N gonorrhoeae strains and C trachomatis is recommended. If Gram negative diplococci are not detected in the presence of microscopic evidence of urethritis, treatment for chlamydial infection alone is recommended.
Hoosen
A A
AA
Department of Medical Microbiology, Faculty of Medicine, University of Natal, Durban, South Africa.
O'Farrell
N
N
van den Ende
J
J
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001437:Bacteriuria / Q000209:etiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D004823:Epididymitis / Q000209:etiology* / Q000382:microbiology / Q000469:parasitology; D004926:Escherichia coli / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D013019:South Africa; D014521:Urethra / Q000382:microbiology / Q000469:parasitology; D014526:Urethritis / Q000382:microbiology / Q000469:parasitology