History and exam

Key diagnostic factors

Approximately 85% of women and men are asymptomatic.[9]

Other diagnostic factors

Examination of the cervical os may reveal a cloudy or yellow discharge.

Cervix may bleed easily with friction from a Dacron swab.

Women may experience postcoital or intermenstrual bleeding.

Mucoid or mucopurulent discharge from the urethral opening. Discharge may appear after applying pressure along the penile shaft.

Odorless mucoid discharge may be present.

Painful urination may be present in either sex but is more common in men.

Can occur in women if the infection ascends to the upper urogenital tract or as a result of early pelvic inflammatory disease (PID).

Can occur in women if the infection ascends to the upper urogenital tract, or rarely secondary to a pericapsular hepatic infection.

Can occur in men in severe infections.

Can occur in women if the infection ascends to the upper urogenital tract.

Can occur in men in severe infections.

Mild to severe scrotal pain may occur in ascending infections that cause epididymitis or prostatitis.[2]

In severe infections, the scrotal area may be tender to touch and feel warm.

Can occur in women if the infection ascends to the upper urogenital tract.

Can occur in women if the infection ascends to the upper urogenital tract. Rarely, right upper quadrant abdominal pain occurs secondary to a pericapsular hepatic infection.

Symptoms and signs of rectal infection are rare, but when present may include mucopurulent rectal discharge or tenesmus.

Risk factors

The risk of infection is greatest in sexually active adolescents and young adults aged less than 25 years.[3][4]

Risk is particularly high if a person has recently changed his or her sexual partner, has multiple sex partners, or has a sex partner with other concurrent sex partners.[4]

Risk is particularly high if there is a history of sexual activity with a person who has a chlamydia infection.

Risk for STIs is increased if condoms are not used.

People with prior STIs should be routinely assessed for re-exposure.[4]

Black people are at higher risk than white people, who are at higher risk than Asian people.[3][8]

Urban residence and low socioeconomic status increase the risk.[8]

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