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Case 15

Gerry presents with dysuria that began yesterday. He did NOT complain of urgency, increased frequency, or of suprapubic pain pre- or post voiding. He mentioned having a white urethral discharge. He also mentioned have an extramarital affair that he ended two days ago. No genital lesions were noted. Some of the discharge (Figure 1) was smeared on a glass slide and gram stained (Figure 2).

Figure 1: Examination of penile discharge	Figure 2: Gram stain of penile discharge

His wife and former love interest were questioned and they did not mention having any vaginal discharge or dysuria.

A. Which of the following is the most appropriate diagnosis for Gerry's current condition?

1. Chlamydia
2. Gonorrhea
3. Cystitis
4. Genital Herpes
5. Genital Warts

B. Gerry was treated with ceftriaxone and doxycycline. In which of the following is doxycycline the drug of choice in treating?

1. Chlamydia
2. Gonorrhea
3. Cystitis
4. Genital Herpes
5. Genital Warts

B. Should Gerry's wife and former love interested be examined and tested?

1. No usually females have symptoms with this infection but rarely if ever develop any complications
2. No this infection is usually self-limiting
3. Yes usually females experience symptoms with this infection and will be making an appointment anyways
4. Yes females are oftentimes asymptomatic and can develop severe complications without treatment

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Site Last Revised 3/24/14
Neal Chamberlain, PhD. A. T. Still University of Health Sciences/Kirksville College of Osteopathic Medicine.

Take Care and Think Microbiologically!