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Nongonococcal Urethritis (NGU)
1990 Case Definition

NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

Clinical Description

Urethral inflammation that is not the result of infection with Neisseria gonorrhoeae. Urethral inflammation may be diagnosed by the presence of one of the following criteria:

  • A visible abnormal urethral discharge (excludes scant amounts of clear mucus)
  • A positive leukocyte esterase test from men less than 60 years of age without a history of kidney disease or bladder infection, prostate enlargement, urogenital anatomic anomaly, or recent urinary tract instrumentation
  • Microscopic evidence of urethritis (greater than or equal to 5 white blood cells (WBC) per high-power field) on a Gram stain of a urethral smear

Laboratory Criteria for Diagnosis

No evidence of N. gonorrhoeae infection by culture or Gram stain

Case Classification

Confirmed

A clinically compatible case among males in whom gonorrhea is not found, either by culture or Gram stain

Comments

Nongonococcal urethritis is a clinical diagnosis of exclusion. The syndrome may result from infection with several agents (see Chlamydia trachomatis, Genital Infection). A clinically compatible case excluding gonorrhea and chlamydia should be classified as NGU. An illness among men that meets the case definition of NGU and C. trachomatis infection should be classified as chlamydia.



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