Sexually transmitted infections Quiz: Ace Your Exams

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A 22-year-old man comes to an outpatient clinic for evaluation of pain and increased frequency of urination for the past four days. The patient endorses penile discharge and is concerned he “may have a urinary tract infection.” The patient is currently sexually active with three partners. Temperature is 37.0°C (98.6°F), pulse is 90/min, respirations are 20/min, and blood pressure is 120/75 mmHg. External genital examination reveals mucopurulent, cloudy discharge at the urethral meatus. Digital rectal exam (DRE) is within normal limits. Findings from a urinalysis are demonstrated below. Gram staining of the discharge is negative for the presence of bacteria. Urine culture is negative for growth at 24 hours. Which of the following findings is most likely to be found on further evaluation?
 
Laboratory value  
Result
Urinalysis  

Color
Cloudy
Specific gravity  
1.013  
Glucose
Negative
Blood
Negative  
Leukocyte esterase  
Large leukocyte esterase  
Nitrites
Negative  
Leukocytes  
50-100/hpf  
Erythrocytes  
1-2/hpf  
Dysmorphic RBCs  
Absent  
Casts  
None

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