Adenovirus and non-gonococcal urethritis

Abstract

Non-gonococcal urethritis (NGU) is a common problem presenting to sexual health clinics that is usually managed empirically. In many cases the aetiology is never clearly established or further investigated. Adenovirus has been identified in the past as an occasional cause of NGU but little has been written about its clinical presentation. We present a case report of 6 men who were diagnosed with NGU caused by adenovirus infection, along with a review of the relevant literature, with the aim of improving clinical recognition of this pathogen.

Adenovirus urethritis and concurrent conjunctivitis: a case series and review of the literature

“…Specific clinical features have previously been recognised that should alert the clinician to considering adenovirus as the cause of NGU13 14 17 and our case series adds further support to this. Tables 1–3 demonstrate the many similarities that occur in patients diagnosed with concurrent adenovirus infection of the urethra and conjunctiva.…”

“…Cross reaction with more than one serotype of adenovirus (ɫ) 14. It was not possible to discriminate from the regions sequenced whether the adenovirus was type 11 or 35 (ɫɫ).…”

“…All of our cases had more than five polymorphonuclear leucocytes per high-powered field and this was a consistent finding in other case reports (table 3). Azariah and Reid14 and Tønsberg and Hartgill18 comment on the identification of large numbers of mononuclear cells on urethral smear and postulate that this could indicate a viral aetiology. We did not look at this in our case series; however, if the patient is symptomatic but does not have microscopic evidence of urethritis, then finding mononuclear cells may alert the clinician to consider adenovirus as the cause.…”

Nongonococcal urethritis: New views through the prism of modern molecular microbiology

“…Of 20 infected men, 75% had urethritis [2•]. Six additional cases were reported more recently from New Zealand [22]. Bradshaw et al [21•] studied 329 NGU cases and compared them to 307 controls in the Melbourne, Australia, Sexual Health Center.…”

“…O'Mahony [25•] published an excellent color photo of adenovirus-associated meatitis. Adenovirus cases tend to occur in the fall and winter and are often associated with conjunctivitis [21][22][23]. Regional lymphadenopathy and constitutional symptoms may be seen with primary HSV urethritis [24].…”