Clinical example urethritis
Urology / / August 12, 2017
patient Ivanov II(Name changed), born in 1968 she turned 13 GKB.complaints: "On pain in the sacral region aching nature, as well as periodic discharge from the urethra during 8 months."The patient had a history of chlamydia (2002), ureaplasmosis (2004), trichomoniasis (2009).Also, the patient was treated in February 2008 on the nonspecific bacterial urethritis with short-term effect (symptoms disappeared one week).The course of treatment consists in the use of antibiotic therapy alternated Rulid 150 mg - 2 times a day and Abaktal 400 mg - 2 times a day for 10 days each drug nystatin 500,000 U - 3 times a day, immunomodeliruyuschaya therapy - used TSikloferon in \ m single injectiona day.
patients underwent complete urological examination.Rectal - age the prostate gland size testovatoy consistency heterogeneous border konturiruyutsya, slightly painful on palpation.Interlobar groove traced.
Microscopy secretion of the prostate: color - yellow, white blood cells - 20-35 in sight, erythrocytes - isolat
Microscopy urethral discharge: epithelial cells - 5-7 in sight, the white blood cells - 20-30 in the preparation, erythrocytes - isolated in the preparation microflora - a large number of Gram-positive staphylococci.
Ultrasound examination of the prostate revealed signs of chronic prostatitis - thickened capsule, the central portion of the breast hypoechoic, hyperechoic inclusions are.
genetic research to identify specific DNA fragments by polymerase chain reaction urethral discharge showed no DNA chlamydia, ureaplasma, mycoplasma, gardenerell, trichomonas.
Bacteriological examination of urethral discharge was detected Staphylococcus aureus, composed antibiotikogrammy.
A survey of the diagnosis: Chronic infection of the lower urinary tract - chronic NGU, chronic bacterial prostatitis.
patient received a course of combination therapy.Immunotherapy - VI-4 vaccine subcutaneously first immunizing dose was 0.1 mg, 0.2 mg next four intervals of administration for three days.Antibiotic treatment (taking into account the results of antibiogram) - ciprofloxacin 250 mg - 2 times a day, Nystatin 500,000 IU.- 3 times a day for 10 days.The patient was also held 10 sessions of massage of the prostate and 10 sessions of ultrasound therapy on the area of the prostate (used device for ultrasound therapy UST - 1.03 V ***).Symptoms disappeared on day 6 from the beginning of treatment.
After a course of antibiotic therapy the patient passed prevention course dysbiosis: Hilak forte 40 drops - 3 times a day and bifidumbakterin 5 doses - 3 times a day for 10 days.A monitoring bacteriological survey conducted a month - the secret of the prostate gland is sterile, the polymerase chain reaction to negative STD pathogens.At follow-up the patient's symptoms were not renewed.