Penile discharge: Difference between revisions

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==Overview==
==Overview==


Penile discharge is commonly associated with [[STD]]s. A thorough sexual history along with a complete medical history and physical exam are necessary. In addition, cultures for STDs should be taken though rarely are nonsexually transmitted diseases the cause. A patient that is not circumscised is at higher risk for STDs.
Penile discharge is commonly associated with [[STD]]'s. A thorough sexual history along with a complete medical history and physical exam are necessary. In addition, cultures for STD's should be taken though rarely are nonsexually transmitted diseases the cause.


== Differential Diagnosis ==  
== Causes==
===Common Causes===
*[[Carcinoma]] of the [[urethra]]
*[[Carcinoma]] of the [[urethra]]
*Foreign body in the [[urethra]]
*Foreign body in the [[urethra]]
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*Nonspecific [[urethritis]]
*Nonspecific [[urethritis]]
*[[Prostatitis]]
*[[Prostatitis]]
*[[Reiter's Syndrome]]
*[[Reiter's syndrome]]


==Risk Factors==
A patient that is not circumscised is at higher risk for STD's.
== Diagnosis ==
== Diagnosis ==


=== History and Symptoms ===  
=== History and Symptoms ===  
*History includes:
*History includes:
:*personal history
:*Personal history
:*sexual history
:*Sexual history
*Note: onset, color, type and duration of discharge
*Note: onset, color, type and duration of discharge


=== Other ===
=== Physical Examination ===
*Genital exam
*Genital exam


== Laboratory Findings ==  
=== Laboratory Findings ===  
*[[Blood culture]]
*[[Blood culture]]
*[[CBC]]
*[[CBC]]
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*[[HIV]]
*[[HIV]]
*[[RPR]]
*[[RPR]]
*Urethral cultures - Gold standard for [[gonorrhea]] and [[chlamydia]]
*Urethral cultures - gold standard for [[gonorrhea]] and [[chlamydia]]
*[[Urinalysis]]
*[[Urinalysis]]
*Wet mount for [[trichomonas]]
*Wet mount for [[trichomonas]]


=== X Ray ===  
=== X Ray ===  
*X-ray for detection of foreign bodies, when necessary
*X-ray for detection of foreign bodies, when necessary.


== Treatment ==
== Treatment ==
*Penile discharge should be treated as an STD until definitivly ruled out
*Penile discharge should be treated as an STD until definitivly ruled out.
== Pharmacotherapy ==
 
===Medical Therapy===
==== Pharmacotherapy ====


=== Acute Pharmacotherapies ===  
===== Acute Pharmacotherapies =====  
*[[Chlamydia]] - PO [[azithromycin]], [[ofloxacin]] for seven days, [[doxycycline]] for seven days or [[erythromycin]] for seven days
*[[Chlamydia]] - PO [[azithromycin]], [[ofloxacin]] for seven days, [[doxycycline]] for seven days or [[erythromycin]] for seven days
*[[Trichomonas]] - Single dose [[metronidazole]] for seven days  
*[[Trichomonas]] - Single dose [[metronidazole]] for seven days  
*[[Gonorrhea]] - [[Ceftriaxone]] single dose IM (in office) / PO [[cefixime]] / [[ciprofloxacin]]
*[[Gonorrhea]] - [[Ceftriaxone]] single dose IM (in office) / PO [[cefixime]] / [[ciprofloxacin]]


== Primary Prevention ==  
=== Primary Prevention ===  
*Suggest the patient inform all sexual partners of disease so they can seek treatment
*Suggest the patient inform all sexual partners of disease so they can seek treatment.
*Discuss safe sexual practice
*Discuss safe sexual practices.


==Related Chapters==
* [[Discharge]]
* [[STD]]'s
==References==
==References==
{{reflist|2}}
{{reflist|2}}
 
{{WH}}
== Acknowledgements ==
{{WS}}
The content on this page was first contributed by {{CMG}}
 
List of contributors:
----
== Suggested Reading and Key General References ==
 
== Suggested Links and Web Resources ==
 
== For Patients ==
 
 


[[Category:Urology]]
[[Category:Urology]]
[[Category:Medical signs]]
[[Category:Symptoms]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
 
[[Category:Needs causes]]
{{WH}}
{{WS}}

Latest revision as of 23:37, 29 July 2020

Template:Search infobox Steven C. Campbell, M.D., Ph.D.

Overview

Penile discharge is commonly associated with STD's. A thorough sexual history along with a complete medical history and physical exam are necessary. In addition, cultures for STD's should be taken though rarely are nonsexually transmitted diseases the cause.

Causes

Common Causes

Risk Factors

A patient that is not circumscised is at higher risk for STD's.

Diagnosis

History and Symptoms

  • History includes:
  • Personal history
  • Sexual history
  • Note: onset, color, type and duration of discharge

Physical Examination

  • Genital exam

Laboratory Findings

X Ray

  • X-ray for detection of foreign bodies, when necessary.

Treatment

  • Penile discharge should be treated as an STD until definitivly ruled out.

Medical Therapy

Pharmacotherapy

Acute Pharmacotherapies

Primary Prevention

  • Suggest the patient inform all sexual partners of disease so they can seek treatment.
  • Discuss safe sexual practices.

Related Chapters

References

Template:WH Template:WS