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GENITAL SYMPTOMS IN A MANFirst assess and advise the man with genital symptoms23 and his partner/s.Urethral discharge ordysuria/burning urineScrotal swelling or painPain or itchiness of glans or inability to retractor reduce foreskinTreat for male urethritis syndrome (MUS):• Cefixime 1 400mg orally stat and• Doxycycline 100mg 12 hourly for 7 days.• Treat patient's partner/s 23.Advise patient to return in 7 days if symptoms persist.Does patient have any of:• Sudden onset of severe pain• Affected testicle is higher• A history of traumaForeskin can be moved easily on examination.If ongoing urethral discharge or dysuria, ask if possiblereinfection or poor adherence.YesRepeat treatment:• Cefixime 1 400mg orally statand• Doxycycline 100mg 12hourly for 7 daysRefer if not resolvedNo• Givemetronidazole2g orally stat.(Avoid alcoholfor 24 hours)YesTorsion oftesticle likely.Refer todoctor sameday.NoTreat for scrotal swelling(SSW):• Ceftriaxone 250mg IM stat.If penicillin allergic giveciprofloxacin 500mg 12hourly for 3 days and• Doxycycline 100mg 12 hourlyfor 14 days.• Treat patient's partner/s 23.Refer if no improvement after7 days.YesTreat for balanitis (BAL)• Wash with weak salt solution, avoidsoap.• Retract foreskin while washing.• Prescribe clotrimazole cream twicedaily.• If no response after 7 days:--Repeat treatment.--Test for diabetes 70 and HIV60.--Treat female partner 23.--If still no better, refer to doctor.NoPhimosis orparaphimosislikely.Refer sameweek todoctor.1Gonococcal resistance to ciprofloxacin is common. If severe penicillin allergic (angioedema, anaphylactic shock or bronchospasm) replace cefixime with ciprofloxacin 500 mg oral stat. Refer if no improvement within 48 hours.TB HIV CHRONIC RESPIRATORYDISEASECHRONIC DISEASESOF LIFESTYLEMENTAL HEALTH EPILEPSY MUSCULOSKELETALDISORDERS24WOMEN'S HEALTH