ORIGINAL ARTICLE Characteristics of adenovirus associated urethritis

Objectives: To describe the characteristics of adenovirus urethritis in men. Method: Cases occurred over a 30 month period among men presenting with urethritis to Melbourne Sexual Health Clinic. All cases had a urethral Gram stain and underwent testing for chlamydia, gonor-rhoea, herpes, and adenovirus. Cases were empirically treated with a macrolide or doxycycline. Results: Eight cases of adenovirus associated urethritis were identified in whom no other causative organism was isolated. Cases were clustered in autumn and winter of each year and all reported recent insertive oral sex and seven reported recent insertive vaginal sex. All patients complained of dysuria, seven had meatitis and mucoid discharge, six had conjunctivitis, and four constitutional symptoms. Three sexual contacts were known to be symptomatic. Conclusion: Adenovirus is an uncommon cause of urethritis in men but it should be considered in all males presenting with dysuria, meatitis, and associated conjunctivitis or constitutional symptoms. Non-specific urethritis (NSU) is a common presentationto sexual health clinics and in a substantial proportionof cases no pathogen is identified. There are few reports of adenovirus associated with urethritis in men, and it is not usually considered when investigating NSU. Adenovirus causes a variety of clinical syndromes charac-terised by inflammation of mucous membranes. There are 47 serotypes; types 8, 19, and 37 (subgenus D) cause keratoconjunctivitis,1–6 but have also been infrequently iso-lated from genital sites in individuals with cervicitis,3–8 urethritis,5 6 9 10 and genital ulcers.6 7 We describe characteristic clinical features in eight men presenting with urethritis to a sexual health clinic in whom adenovirus appears to have been the causative agent