A 23-year-old male presented with a two-week history of dysuria and purulent penile discharge. Gram stain of a urethral swab showed Gram negative intracellular diplococci.
Which one of the following is the most likely causative organism?
Chlamydia trachomatis
Cytomegalovirus -
Mycoplasma hominis
Neisseria gonorrhoeae
Ureaplasma urealyticum
Explanation:
Neisseria gonorrhoeae occurs in young adults and is often preceded by a migratory tendonitis or arthritis. Gram stain is positive in 25% and culture positive in 50%.
Neisseria gonorrhoeae is a species of Gram-negative bacteria responsible for the disease gonorrhoea. They are highly fastidious Gram-negative cocci, that is, they require special nutrients to survive. These cocci typically appear in pairs (diplococci).
Chlamydia trachomatis is an intracellular organism but is difficult to stain with Gram stain which makes gonorrhoea more likely here.
The other three organisms described here do not classically present with these symptoms.