Two Types Of Urethritis
There are two types of urethritis: gonorrheal and non-gonorrheal. Each has a different pathophysiology. (5)
Gonorrheal
The usual transmission of N. gonorrhoeae is via the venereal tract to the human host.
Once attached to the host cell, gonococci undergo a process called parasite-directed endocytosis, through which they become engulfed. The organism will survive within the vacuoles and reproduce.
Gonococcal virulence factors are the following:
- Pili
- The ability to attach to the urethral epithelium
- Cleavage of IgA by extracellular proteases
Non-Gonorrheal
The most common non-gonorrheal cause is Chlamydia trachomatis.
As part of the infection, the host cell attaches to the infection’s surface and starts to phagocytose it. In order to survive inside a cell, the pathogen damages the cellular lysosomes and creates elementary bodies, which are the pathogen’s infectious form.
- Gross Pathology: Mucopurulent discharge, mucoid discharge, or purulent discharge may be seen in gross pathology.
- Microscopy: Gonorrheal
Characteristic findings include
- A Gram-negative intracellular diplococci (GNID) or a purple intracellular diplococci staining with gentian violet or methylene blue.
- Epithelial cells invaded
- Polymorphic nuclei
- Multiple organisms in the same vacuole
- Inflammation signs are present
- Gram-negative intracellular diplococci (GNID) absence