PERIURETHRAL GLAND ABSCESS - ETIOLOGY AND TREATMENT

Objectives: To establish some characteristics of patients with periure thral gland abscess, its microbiological profile, and response to trea tment. Method: The patients were seen at the Khami Road Clinic, Bulawa yo, a municipal STD referral clinic, serving an urban population. Twen ty consecutive men with periurethral abscesses were studied. Demograph ic data and a sexual history were obtained from each patient. Aspirate s from the abscess cavities and urethral swabs were collected for micr obiology, and blood samples taken for syphilis and HIV serology. The p atients were treated by aspiration of the abscess cavities, followed b y a single injection of kanamycin 2.0 g followed by a 1 week course of oral doxycycline 100 mg twice daily. Results: Neisseria gonorrhoeae w as cultured from three aspirates and five urethral specimens. Chlamydi a trachomatis was found in two aspirates and three urethral specimens. Other organisms isolated included Gram negative and anaerobic bacilli . HIV antibody was detected in 13 of 18 patients tested. The response to initial treatment was good, but the abscesses ruptured in two patie nts, one of whom developed a urinary fistula. One patient required tre atment with an alternative antimicrobial regimen. Conclusion: This stu dy demonstrated a role for N gonarrhoeae and possibly for C trachomati s in the aetiology of periurethral abscess. The prevalence of HIV infe ction in these patients was high. The results of treatment of periuret hral abscess by aspiration of pus and followed by antimicrobial therap y covering both N gonorrhoeae and C trachomatis were acceptable.