A young man goes to his physician complaining of a discharge from his penis. The physician collects a slide for Gram stain and a swab for culture and sends them to the laboratory. The Gram stain reveals greater than 25 white blood cells/high-power field, no bacteria seen. The culture results after 48 hours show no growth. What is the most probable diagnosis and the organism responsible?

Question

Quizplus · Accepted Answer

The most likely diagnosis is nongonococcal urethritis (NGU). The presence of white blood cells on the Gram stain indicates inflammation, but the absence of bacteria suggests an infection with an organism that is difficult to culture or a non-infectious cause of urethritis. Chlamydia trachomatis is the most common cause of NGU, accounting for up to 50% of cases. Moraxella and Streptococcus pneumoniae are not common causes of urethritis, and Neisseria meningitidis is associated with meningococcal disease, not urethritis.

A Young Man Goes to His Physician Complaining of a Discharge