Case 1

A 20-year-old male college student presents with the main complaints of dysuria and urethral discharge. He denies a history of fever, chills, nausea, or abdominal pain. He has never had a urinary tract infection. He had Neisseria gonorrhea treated 6 months ago with an unknown antibiotic. He has no significant past medical history.

The only remarkable findings on the physical examination are urethral meatus erythema, a small amount of urethral discharge with milking, but no epididymal. tenderness.

Urethral swabs are obtained. Grain stain of expressible discharge reveals polymorphonuclear leukocytes without any identifiable Gram-negative cocci. Cultures are sent.

Questions

1. "presents with the main complaints of dysuria and urethral discharge" What does this indicate?. What is urethritis? 

2.  What are the major causes of urethritis? 

3. "He had Neisseria gonorrhea treated 6 months ago with an unknown antibiotic". Does that mean we don't have to worry about Gonorrhea in this patient?

4."The only remarkable findings on the physical examination are urethral meatus erythema, a small amount of urethral discharge with milking". What is the significance of this observation?

5. "Urethral swabs are obtained. Grain stain of expressible discharge reveals polymorphonuclear leukocytes without any identifiable Gram-negative cocci. Cultures are sent." How does this information helpful in the differential diagnosis of urethritis?

7. How do you classsify Urethritis?  (Define nongonococcal  urethritis)

8. He had Neisseria gonorrhea treated 6 months ago with an unknown antibiotic". What is the significance of recurrence of symptoms of urethritis following treatment of  gonoccccal urethritis. (postgonoccccal urethritis)

9. Describe the general characteristics of Chlamydia species

10. Name the three species of Chlamydia species

12. What are the other serovarieties of C. trachomatis that can cause infection ?

13. What other sites can be involved with sexually transmitted Chlamydia trachomatis? 

14. List the serovarieties of Chlamydia trachomatis, the diseases they cause, and how each is transmitted.