Streptococcus pyogenes: A rare etiology of non-Gonococcic Urethritis and Balanitis – diagnostic problems in the practice of family medicine and urology – a case study

ntroduction: Urinary tract infections are some of the most common causes of patients consulting with their family doctor for urological reasons. These infections appear particularly often in young women but are also prevalent among sexually active young men. Common infective causes are Candida, Trichomonas, Mycoplasma, Chlamydia, Treponema pallidum. Less frequent agents are group A and B streptococci, human pappiloma viruses and other anaerobic bacteria. Until now, only few cases of urethritis and balanities due to Streptococcus pyogenes were reported. Case Report: This particular case report describes the problem of a 23 year-old patient with severe urethritis and balanitis. He reported to his family doctor after suffering for a few months of undiagnosed illness, and was treated with standard antibiotic therapy prescribed by his family physician. The smear test revealed the infecting agent: Streptococcus pyogenes. Targeted antibiotic therapy diminished his symptoms, but after few weeks the problem recurred more severely. Summary: This case illustrates how important it is to ask the deeper questions while taking a medical history. In this case, a thorough medical history was the key to resolving the patient’s problem. (Clin Exp Med Lett 2009; 50(1)61-62)

Keywords: Streptococcus pyogenes, Urethritis and Balanitis