The term “gleet” is an archaic medical word defining a persistent, low-grade discharge, typically from the urethra. This language is no longer used in standard medical practice. Historically, it described a chronic, non-acute fluid release that often persisted after the initial, severe stage of a genitourinary infection had passed. Modern medical diagnoses focus on inflammation of the urethra and the specific infectious or non-infectious agents responsible.
The Historical Definition of Gleet
For centuries, before modern microbiology and antibiotics, “gleet” was a common term in medical texts, particularly related to venereal diseases. It referred to the thin, mucoid, and often watery discharge that lingered after the intense, purulent flow of an acute infection, such as gonorrhea, had subsided. This chronic discharge represented persistent, low-grade inflammation within the urethra, often indicating a long-standing or poorly treated infection.
The term itself is thought to derive from Old French for “slime” or “sticky.” Medical practitioners used this symptom-based naming because they lacked the tools to identify specific bacterial or viral causes. The term fell out of favor as scientific understanding advanced in the late 19th and early 20th centuries. With the identification of causative agents like Neisseria gonorrhoeae, doctors shifted toward a pathology-based nomenclature, moving away from symptom descriptions alone.
Modern Medical Diagnosis and Underlying Causes
A persistent urethral discharge, the symptom once called gleet, is now medically classified as chronic urethritis, or persistent or recurrent non-gonococcal urethritis (NGU). This modern diagnosis reflects the underlying inflammation of the urethra and focuses on determining the precise etiology. The defining characteristic is objectively measurable inflammation, often confirmed by the presence of white blood cells in a urine sample or urethral swab.
The most common infectious causes of this chronic inflammation are sexually transmitted organisms other than gonorrhea. Pathogens such as Chlamydia trachomatis and Mycoplasma genitalium are frequently identified in NGU cases, with M. genitalium being common in persistent cases following initial treatment. Other infectious agents include Ureaplasma urealyticum and Trichomonas vaginalis.
A significant minority of chronic urethritis cases, estimated to be between 25% and 30%, remain without an identifiable microbial cause even after extensive testing. Non-infectious factors may also contribute to the persistent inflammation. These include physical irritation from a urinary catheter, local trauma, or sensitivity to chemicals in products like spermicides.
Characteristics and Current Treatment Strategies
The discharge formerly known as gleet is thin, clear, or mucoid, and often scanty. Patients frequently notice the subtle discharge first thing in the morning. The symptom is associated with inflammation of the urethra and may include mild pain or a burning sensation during urination.
Diagnosis begins with molecular testing, such as nucleic acid amplification tests (NAATs), performed on a first-void urine sample or urethral swab. Testing aims to identify specific pathogens, including N. gonorrhoeae, C. trachomatis, and M. genitalium, to guide treatment. This pathogen-specific testing replaces the historical reliance on visual symptom description.
Treatment is tailored to the identified organism, usually involving targeted antibiotics. For uncomplicated NGU, first-line therapy involves a seven-day course of doxycycline or a multi-day course of azithromycin. For persistent or recurrent cases, especially those involving M. genitalium, a multi-step regimen may be necessary, sometimes including a second-line antibiotic like moxifloxacin, due to rising antimicrobial resistance.