Approach

An accurate history is essential to help differentiate between infectious and non-infectious causes of urethritis. A sexually active person presenting with urethral discharge or irritation should be evaluated for gonococcal urethritis (GU) and non-gonococcal urethritis (NGU). The criteria for clinical diagnosis usually include documenting urethral discharge, along with ≥ 2 polymorphonuclear leukocytes (PMNs) per high power field in the discharge or ≥10 in sediment from a first-void urine. Urine culture will be negative for enteric pathogens. Because of significant overlap in symptoms, GU and NGU should not be differentiated clinically.[2][27]

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