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Gonorrh\u00e9e Neisseria gonorrhoeae, Chlamydia trachomatis, TAAN, ceftriaxone doxycycline et d\u00e9pistage des partenaires au Qu\u00e9bec.\">\n<meta name=\"keywords\" content=\"ur\u00e9trite, ur\u00e9trite gonorrh\u00e9e, ur\u00e9trite Chlamydia, Neisseria gonorrhoeae, Chlamydia trachomatis, ur\u00e9trite traitement, ceftriaxone gonorrh\u00e9e, doxycycline Chlamydia, TAAN ur\u00e9trite, ur\u00e9trite Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=dump');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Infectiologie & Urologie & M\u00e9decine de famille<\/span>\n <h1>Ur\u00e9trite<\/h1>\n\n <div class=\"co-intro\">\n L'ur\u00e9trite est une inflammation de la muqueuse ur\u00e9trale caus\u00e9e le plus souvent par une infection sexuellement transmissible (IST) \u2014 constituant l'une des IST les plus fr\u00e9quentes dans le monde + avec une incidence annuelle estim\u00e9e \u00e0 plus de 150 millions de cas pour la seule gonorrh\u00e9e et \u00e0 plus de 130 millions pour les infections \u00e0 <em>Chlamydia trachomatis<\/em> according to the WHO. Urethritis classically presents with a triad of symptoms in men: dysuria (burning urination) + urethral discharge + and erythematous meatus \u2014 although many cases are asymptomatic (particularly Chlamydia + Mycoplasma + and Ureaplasma infections) and diagnosed only through systematic screening. In women, the presentation is often less specific and can mimic cystitis + cervicitis + or be completely silent. The classic classification distinguishes gonococcal urethritis (GU \u2014 caused by <em>Neisseria gonorrhoeae<\/em>) + characterized by abundant purulent discharge (frank pus) + rapid onset (2\u20137 days) + and non-gonococcal urethritis (NGU) + mainly caused by <em>Chlamydia trachomatis<\/em> (30\u201350 % of the UNG) + <em>Mycoplasma genitalium<\/em> (15\u201325 %) + <em>Ureaplasma urealyticum<\/em> and other agents\u2014the discharge is often clear, mucoid, less abundant, sometimes only present in the morning. However, this clinical distinction is imperfect because coinfections of gonorrhea and Chlamydia are frequent (20\u201340 % of gonorrhea cases), justifying the systematic treatment of both agents when gonorrhea is confirmed or strongly suspected. The increasing resistance of <em>N. gonorrhoeae<\/em> to antibiotics (fluoroquinolones + penicillins + tetracyclines + and emergence of resistance to 3rd generation cephalosporins) constitutes a major public health challenge\u2014requiring continuous surveillance of resistance profiles and regular adaptation of therapeutic protocols.\n <\/div>\n\n <h2>Agents pathog\u00e8nes et pr\u00e9sentation clinique<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Agent<\/th>\n <th>Frequency<\/th>\n <th>Clinical presentation<\/th>\n <th>Incubation<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Neisseria gonorrhoeae (gonorrh\u00e9e)<\/td>\n <td>Ur\u00e9trite gonococcique \u2014 tr\u00e8s fr\u00e9quente<\/td>\n <td>\u00c9coulement ur\u00e9tral purulent abondant (pus jaune-vert) + dysurie intense + m\u00e9at \u00e9ryth\u00e9mateux + prurit ur\u00e9tral + souvent symptomatique chez l'homme + asymptomatique chez la femme dans 50 % des cas<\/td>\n <td>2\u20137 jours<\/td>\n <\/tr>\n <tr>\n <td>Chlamydia trachomatis<\/td>\n <td>30\u201350 % des ur\u00e9trites non gonococciques<\/td>\n <td>\u00c9coulement muco\u00efde clair + peu abondant + parfois uniquement matinal (\u00abgoutte du bonjour\u00bb) + dysurie mod\u00e9r\u00e9e + souvent asymptomatique (50\u201370 % des hommes + 70\u201380 % des femmes)<\/td>\n <td>7\u201321 jours<\/td>\n <\/tr>\n <tr>\n <td>Mycoplasma genitalium<\/td>\n <td>15\u201325 % des ur\u00e9trites non gonococciques<\/td>\n <td>Similaire \u00e0 Chlamydia + souvent asymptomatique + tendance \u00e0 la chronicit\u00e9 si non trait\u00e9e + r\u00e9sistances aux macrolides \u00e9mergentes (azithromycine) \u2192 d\u00e9pistage de la r\u00e9sistance recommand\u00e9<\/td>\n <td>Variable \u2014 1\u20133 semaines<\/td>\n <\/tr>\n <tr>\n <td>Ureaplasma urealyticum<\/td>\n <td>10\u201320 %<\/td>\n <td>R\u00f4le pathog\u00e8ne parfois discut\u00e9 + souvent asymptomatique + peut causer des ur\u00e9trites l\u00e9g\u00e8res + orchite + infertilit\u00e9 masculine<\/td>\n <td>Variable<\/td>\n <\/tr>\n <tr>\n <td>Trichomonas vaginalis<\/td>\n <td>5-10 %<\/td>\n <td>Prurit ur\u00e9tral + \u00e9coulement clair + souvent asymptomatique chez l'homme (r\u00e9servoir) + voir fiche d\u00e9di\u00e9e<\/td>\n <td>5\u201328 jours<\/td>\n <\/tr>\n <tr>\n <td>Herpes simplex virus (HSV-2)<\/td>\n <td>Rare (1\u20132 %)<\/td>\n <td>Dysuries intenses + v\u00e9sicules\/ulc\u00e9rations sur le m\u00e9at + ad\u00e9nopathies inguinales + fi\u00e8vre + primo-infection souvent s\u00e9v\u00e8re<\/td>\n <td>2\u201312 jours<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Diagnosis<\/h2>\n <ul class=\"co-list\">\n <li><strong>NAAT (nucleic acid amplification test - PCR) :<\/strong> reference test for the detection of <em>N. gonorrhoeae<\/em> + <em>Chlamydia trachomatis<\/em> + <em>Mycoplasma genitalium<\/em> \u2192 sensibilit\u00e9 > 95 % + sp\u00e9cificit\u00e9 > 99 % + pr\u00e9l\u00e8vement : premier jet d'urine du matin (\u2265 1 h sans uriner avant) + ou \u00e9couvillonnage ur\u00e9tral + ou pharyng\u00e9 + ou rectal selon les pratiques sexuelles \u2192 test de choix pour le d\u00e9pistage et le diagnostic<\/li>\n <li><strong>Pr\u00e9l\u00e8vement ur\u00e9tral + frottis + culture :<\/strong> culture with antibiogram for <em>N. gonorrhoeae<\/em> \u2192 indispensable for resistance monitoring + and if treatment failure + less sensitive than NAT but provides resistance data<\/li>\n <li><strong>Examen microscopique direct du frottis ur\u00e9tral :<\/strong> Gram stain \u2192 intracellular Gram-negative diplococci (IGND) = presumptive gonorrhea (95% sensitivity % in symptomatic men + 50\u201360% % in asymptomatic men) + \u2265 5 neutrophils per field = confirmed urethritis<\/li>\n <li><strong>Bilan compl\u00e9mentaire syst\u00e9matique :<\/strong> HIV serology + syphilis + HBV + HCV + Chlamydia + gonorrhea + M. genitalium NAATs as per practice + CBC if fever + renal panel if complications<\/li>\n <li><strong>Sites extra-g\u00e9nitaux :<\/strong> pharynx (oral sex) + rectum (receptive anal sex) \u2192 Nucleic acid amplification testing on a pharyngeal and\/or rectal swab according to reported sexual practices \u2192 do not miss co-existing pharyngeal or rectal gonorrhea<\/li>\n <\/ul>\n\n <h2>Treatment<\/h2>\n <ul class=\"co-list\">\n <li><strong>Gonorrh\u00e9e (N. gonorrhoeae) \u2014 traitement de choix (lignes directrices Sant\u00e9 Canada + ITSS Qu\u00e9bec 2023) :<\/strong> ceftriaxone 500 mg IM dose unique (ou 1 g IM si poids > 150 kg) \u2192 traitement de r\u00e9f\u00e9rence en raison des r\u00e9sistances croissantes + si co-infection Chlamydia non exclue \u2192 ajouter doxycycline 100 mg \u00d7 2\/j \u00d7 7 jours (ou azithromycine 1 g dose unique si doxycycline impossible)<\/li>\n <li><strong>Gonorrh\u00e9e \u2014 traitement alternatif si contre-indication \u00e0 la ceftriaxone :<\/strong> cefexime 800 mg orally once (less effective on resistant strains) \u2192 only if documented sensitivity + or if allergy to cephalosporins: gentamicin 240 mg IM + azithromycin 2 g orally (single dose) \u2192 always confirm with a control NAAT at 7\u201314 days<\/li>\n <li><strong>Chlamydia trachomatis \u2014 traitement de choix :<\/strong> doxycycline 100 mg twice daily for 7 days compared to single-dose azithromycin (eradication rate 98 % vs 77 % + especially for rectal infections) or 1g single-dose oral azithromycin if compliance is doubtful or in pregnant women (doxycycline contraindicated)<\/li>\n <li><strong>Mycoplasma genitalium \u2014 algorithme selon r\u00e9sistance :<\/strong> doxycycline 100 mg twice daily for 7 days (reduction of parasite load + not curative alone) \u2192 then azithromycin 1 g on day 1 + 500 mg on days 2-4 (if no macrolide resistance on NAAT) + or moxifloxacin 400 mg\/day for 7\u201314 days if macrolide resistance + follow-up NAAT at 5\u20136 weeks is essential<\/li>\n <li><strong>Co-infection syst\u00e9matique :<\/strong> if gonorrhea confirmed or strongly suspected \u2192 treat simultaneously for Chlamydia (doxycycline 7 days) + due to the high frequency of co-infections<\/li>\n <li><strong>Partner notification and processing:<\/strong> Notification of all sexual partners from the 60 days preceding diagnosis (gonorrhea + Chlamydia) + offer presumptive testing and treatment to partners + counseling + STI Quebec: Mandatory reporting of gonorrhea and Chlamydia<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>La gonorrh\u00e9e est devenue une \u00absuperbact\u00e9rie\u00bb antimicrobienne prioritaire de l'OMS \u2014 avec des souches r\u00e9sistantes \u00e0 presque toutes les classes d'antibiotiques disponibles (p\u00e9nicillines + t\u00e9tracyclines + fluoroquinolones + macrolides + et m\u00eame des r\u00e9sistances \u00e9mergentes aux c\u00e9phalosporines de 3e g\u00e9n\u00e9ration). Au Qu\u00e9bec, les fluoroquinolones (ciprofloxacine) ne doivent plus \u00eatre utilis\u00e9es pour traiter la gonorrh\u00e9e en raison d'un taux de r\u00e9sistance >30 %. La ceftriaxone IM reste le traitement de choix \u2014 mais des cas de r\u00e9sistance de haut niveau \u00e0 la ceftriaxone ont \u00e9t\u00e9 rapport\u00e9s mondialement. Toute gonorrh\u00e9e doit faire l'objet d'une culture avec antibiogramme pour surveiller les r\u00e9sistances.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin rapidement si un \u00e9coulement ur\u00e9tral + des br\u00fblures mictionnelles + ou une douleur testiculaire apparaissent \u2014 particuli\u00e8rement apr\u00e8s un rapport sexuel non prot\u00e9g\u00e9 \u2014 car une gonorrh\u00e9e ou une Chlamydia non trait\u00e9e peut progresser vers une \u00e9pididymite + une orchite + ou une diss\u00e9mination bact\u00e9rienne (arthrite + dermatite gonorrh\u00e9ique). Toute IST confirm\u00e9e doit \u00eatre d\u00e9clar\u00e9e \u00e0 la Sant\u00e9 publique du Qu\u00e9bec (gonorrh\u00e9e + Chlamydia = MADO). Pour le d\u00e9pistage + le TAAN + et le traitement des IST ur\u00e9trales, Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron r\u00e9alisent le bilan complet des IST (TAAN gonorrh\u00e9e + Chlamydia + M. genitalium + s\u00e9rologies VIH + syphilis + VHB), traitent l'ur\u00e9trite gonococcique par ceftriaxone 500 mg IM dose unique + doxycycline 7 jours pour Chlamydia, d\u00e9pistent les sites extra-g\u00e9nitaux selon les pratiques sexuelles (pharynx + rectum), informent sur la notification et le traitement des partenaires, et d\u00e9clarent les infections \u00e0 la Sant\u00e9 publique (MADO). Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin. La gonorrh\u00e9e et l'infection \u00e0 Chlamydia sont des maladies \u00e0 d\u00e9claration obligatoire (MADO) au Qu\u00e9bec \u2014 tout cas confirm\u00e9 doit \u00eatre d\u00e9clar\u00e9 \u00e0 la Direction r\u00e9gionale de sant\u00e9 publique. La r\u00e9sistance croissante de N. gonorrhoeae impose d'\u00e9viter les fluoroquinolones et de r\u00e9aliser une culture avec antibiogramme \u00e0 chaque cas de gonorrh\u00e9e. Tous les partenaires sexuels des 60 jours pr\u00e9c\u00e9dant le diagnostic doivent \u00eatre notifi\u00e9s et trait\u00e9s.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Ur\u00e9trite : gonorrh\u00e9e, Chlamydia, diagnostic et traitement | Clinique Omicron Infectiologie & Urologie & M\u00e9decine de famille Ur\u00e9trite L’ur\u00e9trite est une inflammation de la muqueuse ur\u00e9trale caus\u00e9e le plus souvent par une infection sexuellement transmissible (IST) \u2014 constituant l’une des IST les plus fr\u00e9quentes dans le monde + avec une incidence annuelle estim\u00e9e \u00e0 plus… <a href=\"https:\/\/cliniqueomicron.ca\/en\/uretrite\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Urethritis: Gonorrhea, Chlamydia, Diagnosis, and Treatment | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Ur\u00e9trite: Sympt\u00f4mes et Traitement \u00e0 Brossard | Clinique Omicron","_metasync_otto_description":"Ur\u00e9trite : Consultez Clinique Omicron \u00e0 Brossard pour une \u00e9valuation m\u00e9dicale et un traitement adapt\u00e9. Soulagement rapide des sympt\u00f4mes. Prenez rendez-vous!","_metasync_otto_keywords":"uretrite, sympt\u00f4mes de l'ur\u00e9trite, traitement de l'ur\u00e9trite, consultation m\u00e9dicale, \u00e9valuation de la sant\u00e9, soins m\u00e9dicaux, clinique de sant\u00e9, Clinique Omicron","_metasync_otto_og_title":"","_metasync_otto_og_description":"Ur\u00e9trite Ur\u00e9trite est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de la sant\u00e9 \u00e0 la Clinique...","_metasync_otto_twitter_title":"","_metasync_otto_twitter_description":"Ur\u00e9trite Ur\u00e9trite est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. 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\n\t\t\t\t\t\n\n\n\n\nUrethritis: Gonorrhea, Chlamydia, Diagnosis, and Treatment | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"L'ur\u00e9trite est une inflammation de l'ur\u00e8tre caus\u00e9e par une infection sexuellement transmissible. Gonorrh\u00e9e Neisseria gonorrhoeae, Chlamydia trachomatis, TAAN, ceftriaxone doxycycline et d\u00e9pistage des partenaires au Qu\u00e9bec.\">\n<meta name=\"keywords\" content=\"ur\u00e9trite, ur\u00e9trite gonorrh\u00e9e, ur\u00e9trite Chlamydia, Neisseria gonorrhoeae, Chlamydia trachomatis, ur\u00e9trite traitement, ceftriaxone gonorrh\u00e9e, doxycycline Chlamydia, TAAN ur\u00e9trite, ur\u00e9trite Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=dump');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Infectiologie & Urologie & M\u00e9decine de famille<\/span>\n <h1>Ur\u00e9trite<\/h1>\n\n <div class=\"co-intro\">\n L'ur\u00e9trite est une inflammation de la muqueuse ur\u00e9trale caus\u00e9e le plus souvent par une infection sexuellement transmissible (IST) \u2014 constituant l'une des IST les plus fr\u00e9quentes dans le monde + avec une incidence annuelle estim\u00e9e \u00e0 plus de 150 millions de cas pour la seule gonorrh\u00e9e et \u00e0 plus de 130 millions pour les infections \u00e0 <em>Chlamydia trachomatis<\/em> according to the WHO. Urethritis classically presents with a triad of symptoms in men: dysuria (burning urination) + urethral discharge + and erythematous meatus \u2014 although many cases are asymptomatic (particularly Chlamydia + Mycoplasma + and Ureaplasma infections) and diagnosed only through systematic screening. In women, the presentation is often less specific and can mimic cystitis + cervicitis + or be completely silent. The classic classification distinguishes gonococcal urethritis (GU \u2014 caused by <em>Neisseria gonorrhoeae<\/em>) + characterized by abundant purulent discharge (frank pus) + rapid onset (2\u20137 days) + and non-gonococcal urethritis (NGU) + mainly caused by <em>Chlamydia trachomatis<\/em> (30\u201350 % of the UNG) + <em>Mycoplasma genitalium<\/em> (15\u201325 %) + <em>Ureaplasma urealyticum<\/em> and other agents\u2014the discharge is often clear, mucoid, less abundant, sometimes only present in the morning. However, this clinical distinction is imperfect because coinfections of gonorrhea and Chlamydia are frequent (20\u201340 % of gonorrhea cases), justifying the systematic treatment of both agents when gonorrhea is confirmed or strongly suspected. The increasing resistance of <em>N. gonorrhoeae<\/em> to antibiotics (fluoroquinolones + penicillins + tetracyclines + and emergence of resistance to 3rd generation cephalosporins) constitutes a major public health challenge\u2014requiring continuous surveillance of resistance profiles and regular adaptation of therapeutic protocols.\n <\/div>\n\n <h2>Agents pathog\u00e8nes et pr\u00e9sentation clinique<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Agent<\/th>\n <th>Frequency<\/th>\n <th>Clinical presentation<\/th>\n <th>Incubation<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Neisseria gonorrhoeae (gonorrh\u00e9e)<\/td>\n <td>Ur\u00e9trite gonococcique \u2014 tr\u00e8s fr\u00e9quente<\/td>\n <td>\u00c9coulement ur\u00e9tral purulent abondant (pus jaune-vert) + dysurie intense + m\u00e9at \u00e9ryth\u00e9mateux + prurit ur\u00e9tral + souvent symptomatique chez l'homme + asymptomatique chez la femme dans 50 % des cas<\/td>\n <td>2\u20137 jours<\/td>\n <\/tr>\n <tr>\n <td>Chlamydia trachomatis<\/td>\n <td>30\u201350 % des ur\u00e9trites non gonococciques<\/td>\n <td>\u00c9coulement muco\u00efde clair + peu abondant + parfois uniquement matinal (\u00abgoutte du bonjour\u00bb) + dysurie mod\u00e9r\u00e9e + souvent asymptomatique (50\u201370 % des hommes + 70\u201380 % des femmes)<\/td>\n <td>7\u201321 jours<\/td>\n <\/tr>\n <tr>\n <td>Mycoplasma genitalium<\/td>\n <td>15\u201325 % des ur\u00e9trites non gonococciques<\/td>\n <td>Similaire \u00e0 Chlamydia + souvent asymptomatique + tendance \u00e0 la chronicit\u00e9 si non trait\u00e9e + r\u00e9sistances aux macrolides \u00e9mergentes (azithromycine) \u2192 d\u00e9pistage de la r\u00e9sistance recommand\u00e9<\/td>\n <td>Variable \u2014 1\u20133 semaines<\/td>\n <\/tr>\n <tr>\n <td>Ureaplasma urealyticum<\/td>\n <td>10\u201320 %<\/td>\n <td>R\u00f4le pathog\u00e8ne parfois discut\u00e9 + souvent asymptomatique + peut causer des ur\u00e9trites l\u00e9g\u00e8res + orchite + infertilit\u00e9 masculine<\/td>\n <td>Variable<\/td>\n <\/tr>\n <tr>\n <td>Trichomonas vaginalis<\/td>\n <td>5-10 %<\/td>\n <td>Prurit ur\u00e9tral + \u00e9coulement clair + souvent asymptomatique chez l'homme (r\u00e9servoir) + voir fiche d\u00e9di\u00e9e<\/td>\n <td>5\u201328 jours<\/td>\n <\/tr>\n <tr>\n <td>Herpes simplex virus (HSV-2)<\/td>\n <td>Rare (1\u20132 %)<\/td>\n <td>Dysuries intenses + v\u00e9sicules\/ulc\u00e9rations sur le m\u00e9at + ad\u00e9nopathies inguinales + fi\u00e8vre + primo-infection souvent s\u00e9v\u00e8re<\/td>\n <td>2\u201312 jours<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Diagnosis<\/h2>\n <ul class=\"co-list\">\n <li><strong>NAAT (nucleic acid amplification test - PCR) :<\/strong> reference test for the detection of <em>N. gonorrhoeae<\/em> + <em>Chlamydia trachomatis<\/em> + <em>Mycoplasma genitalium<\/em> \u2192 sensibilit\u00e9 > 95 % + sp\u00e9cificit\u00e9 > 99 % + pr\u00e9l\u00e8vement : premier jet d'urine du matin (\u2265 1 h sans uriner avant) + ou \u00e9couvillonnage ur\u00e9tral + ou pharyng\u00e9 + ou rectal selon les pratiques sexuelles \u2192 test de choix pour le d\u00e9pistage et le diagnostic<\/li>\n <li><strong>Pr\u00e9l\u00e8vement ur\u00e9tral + frottis + culture :<\/strong> culture with antibiogram for <em>N. gonorrhoeae<\/em> \u2192 indispensable for resistance monitoring + and if treatment failure + less sensitive than NAT but provides resistance data<\/li>\n <li><strong>Examen microscopique direct du frottis ur\u00e9tral :<\/strong> Gram stain \u2192 intracellular Gram-negative diplococci (IGND) = presumptive gonorrhea (95% sensitivity % in symptomatic men + 50\u201360% % in asymptomatic men) + \u2265 5 neutrophils per field = confirmed urethritis<\/li>\n <li><strong>Bilan compl\u00e9mentaire syst\u00e9matique :<\/strong> HIV serology + syphilis + HBV + HCV + Chlamydia + gonorrhea + M. genitalium NAATs as per practice + CBC if fever + renal panel if complications<\/li>\n <li><strong>Sites extra-g\u00e9nitaux :<\/strong> pharynx (oral sex) + rectum (receptive anal sex) \u2192 Nucleic acid amplification testing on a pharyngeal and\/or rectal swab according to reported sexual practices \u2192 do not miss co-existing pharyngeal or rectal gonorrhea<\/li>\n <\/ul>\n\n <h2>Treatment<\/h2>\n <ul class=\"co-list\">\n <li><strong>Gonorrh\u00e9e (N. gonorrhoeae) \u2014 traitement de choix (lignes directrices Sant\u00e9 Canada + ITSS Qu\u00e9bec 2023) :<\/strong> ceftriaxone 500 mg IM dose unique (ou 1 g IM si poids > 150 kg) \u2192 traitement de r\u00e9f\u00e9rence en raison des r\u00e9sistances croissantes + si co-infection Chlamydia non exclue \u2192 ajouter doxycycline 100 mg \u00d7 2\/j \u00d7 7 jours (ou azithromycine 1 g dose unique si doxycycline impossible)<\/li>\n <li><strong>Gonorrh\u00e9e \u2014 traitement alternatif si contre-indication \u00e0 la ceftriaxone :<\/strong> cefexime 800 mg orally once (less effective on resistant strains) \u2192 only if documented sensitivity + or if allergy to cephalosporins: gentamicin 240 mg IM + azithromycin 2 g orally (single dose) \u2192 always confirm with a control NAAT at 7\u201314 days<\/li>\n <li><strong>Chlamydia trachomatis \u2014 traitement de choix :<\/strong> doxycycline 100 mg twice daily for 7 days compared to single-dose azithromycin (eradication rate 98 % vs 77 % + especially for rectal infections) or 1g single-dose oral azithromycin if compliance is doubtful or in pregnant women (doxycycline contraindicated)<\/li>\n <li><strong>Mycoplasma genitalium \u2014 algorithme selon r\u00e9sistance :<\/strong> doxycycline 100 mg twice daily for 7 days (reduction of parasite load + not curative alone) \u2192 then azithromycin 1 g on day 1 + 500 mg on days 2-4 (if no macrolide resistance on NAAT) + or moxifloxacin 400 mg\/day for 7\u201314 days if macrolide resistance + follow-up NAAT at 5\u20136 weeks is essential<\/li>\n <li><strong>Co-infection syst\u00e9matique :<\/strong> if gonorrhea confirmed or strongly suspected \u2192 treat simultaneously for Chlamydia (doxycycline 7 days) + due to the high frequency of co-infections<\/li>\n <li><strong>Partner notification and processing:<\/strong> Notification of all sexual partners from the 60 days preceding diagnosis (gonorrhea + Chlamydia) + offer presumptive testing and treatment to partners + counseling + STI Quebec: Mandatory reporting of gonorrhea and Chlamydia<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>La gonorrh\u00e9e est devenue une \u00absuperbact\u00e9rie\u00bb antimicrobienne prioritaire de l'OMS \u2014 avec des souches r\u00e9sistantes \u00e0 presque toutes les classes d'antibiotiques disponibles (p\u00e9nicillines + t\u00e9tracyclines + fluoroquinolones + macrolides + et m\u00eame des r\u00e9sistances \u00e9mergentes aux c\u00e9phalosporines de 3e g\u00e9n\u00e9ration). Au Qu\u00e9bec, les fluoroquinolones (ciprofloxacine) ne doivent plus \u00eatre utilis\u00e9es pour traiter la gonorrh\u00e9e en raison d'un taux de r\u00e9sistance >30 %. La ceftriaxone IM reste le traitement de choix \u2014 mais des cas de r\u00e9sistance de haut niveau \u00e0 la ceftriaxone ont \u00e9t\u00e9 rapport\u00e9s mondialement. Toute gonorrh\u00e9e doit faire l'objet d'une culture avec antibiogramme pour surveiller les r\u00e9sistances.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin rapidement si un \u00e9coulement ur\u00e9tral + des br\u00fblures mictionnelles + ou une douleur testiculaire apparaissent \u2014 particuli\u00e8rement apr\u00e8s un rapport sexuel non prot\u00e9g\u00e9 \u2014 car une gonorrh\u00e9e ou une Chlamydia non trait\u00e9e peut progresser vers une \u00e9pididymite + une orchite + ou une diss\u00e9mination bact\u00e9rienne (arthrite + dermatite gonorrh\u00e9ique). Toute IST confirm\u00e9e doit \u00eatre d\u00e9clar\u00e9e \u00e0 la Sant\u00e9 publique du Qu\u00e9bec (gonorrh\u00e9e + Chlamydia = MADO). Pour le d\u00e9pistage + le TAAN + et le traitement des IST ur\u00e9trales, Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron r\u00e9alisent le bilan complet des IST (TAAN gonorrh\u00e9e + Chlamydia + M. genitalium + s\u00e9rologies VIH + syphilis + VHB), traitent l'ur\u00e9trite gonococcique par ceftriaxone 500 mg IM dose unique + doxycycline 7 jours pour Chlamydia, d\u00e9pistent les sites extra-g\u00e9nitaux selon les pratiques sexuelles (pharynx + rectum), informent sur la notification et le traitement des partenaires, et d\u00e9clarent les infections \u00e0 la Sant\u00e9 publique (MADO). Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin. La gonorrh\u00e9e et l'infection \u00e0 Chlamydia sont des maladies \u00e0 d\u00e9claration obligatoire (MADO) au Qu\u00e9bec \u2014 tout cas confirm\u00e9 doit \u00eatre d\u00e9clar\u00e9 \u00e0 la Direction r\u00e9gionale de sant\u00e9 publique. La r\u00e9sistance croissante de N. gonorrhoeae impose d'\u00e9viter les fluoroquinolones et de r\u00e9aliser une culture avec antibiogramme \u00e0 chaque cas de gonorrh\u00e9e. Tous les partenaires sexuels des 60 jours pr\u00e9c\u00e9dant le diagnostic doivent \u00eatre notifi\u00e9s et trait\u00e9s.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Ur\u00e9trite : gonorrh\u00e9e, Chlamydia, diagnostic et traitement | Clinique Omicron Infectiologie & Urologie & M\u00e9decine de famille Ur\u00e9trite L’ur\u00e9trite est une inflammation de la muqueuse ur\u00e9trale caus\u00e9e le plus souvent par une infection sexuellement transmissible (IST) \u2014 constituant l’une des IST les plus fr\u00e9quentes dans le monde + avec une incidence annuelle estim\u00e9e \u00e0 plus… <a href=\"https:\/\/cliniqueomicron.ca\/en\/uretrite\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Urethritis: Gonorrhea, Chlamydia, Diagnosis, and Treatment | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Ur\u00e9trite: Sympt\u00f4mes et Traitement \u00e0 Brossard | Clinique Omicron","_metasync_otto_description":"Ur\u00e9trite : Consultez Clinique Omicron \u00e0 Brossard pour une \u00e9valuation m\u00e9dicale et un traitement adapt\u00e9. Soulagement rapide des sympt\u00f4mes. Prenez rendez-vous!","_metasync_otto_keywords":"uretrite, sympt\u00f4mes de l'ur\u00e9trite, traitement de l'ur\u00e9trite, consultation m\u00e9dicale, \u00e9valuation de la sant\u00e9, soins m\u00e9dicaux, clinique de sant\u00e9, Clinique Omicron","_metasync_otto_og_title":"","_metasync_otto_og_description":"Ur\u00e9trite Ur\u00e9trite est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de la sant\u00e9 \u00e0 la Clinique...","_metasync_otto_twitter_title":"","_metasync_otto_twitter_description":"Ur\u00e9trite Ur\u00e9trite est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. 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