A previously healthy 19-year-old man comes to the physician with right-sided, dull, throbbing scrotal pain for 12 hours. He has also had a burning sensation on urination and increased urinary frequency for the past 3 days. He has not had urethral discharge. He is sexually active with one female partner and does not use condoms. Vital signs are within normal limits. Physical examination shows a tender right testicle; lifting it provides relief. The penis appears normal, with no discharge at the meatus. Diagnostic testing reveals Chlamydia trachomatis as the sole causative pathogen. Which of the following additional results are most consistent with this patient's diagnosis?

Question

A previously healthy 19-year-old man comes to the physician with right-sided, dull, throbbing scrotal pain for 12 hours. He has also had a burning sensation on urination and increased urinary frequency for the past 3 days. He has not had urethral discharge. He is sexually active with one female partner and does not use condoms. Vital signs are within normal limits. Physical examination shows a tender right testicle; lifting it provides relief. The penis appears normal, with no discharge at the meatus. Diagnostic testing reveals Chlamydia trachomatis as the sole causative pathogen.  Which of the following additional results are most consistent with this patient's diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Urinalysis in patients with Chlamydia trachomatis infection classically shows sterile pyuria (positive urine white blood cells, no bacteria on Gram stain, no growth on culture) because the C trachomatis bacterium is an obligate intracellular parasite with minimal peptidoglycan in its cell wall.  The diagnostic test of choice is nucleic acid amplification testing.

A Previously Healthy 19-Year-Old Man Comes to the Physician with Right-Sided