Differential Diagnosis for Chlamydia or Gonorrhea Urethritis
- Single most likely diagnosis
- Chlamydia trachomatis infection: This is the most common cause of urethritis, especially in young, sexually active individuals. Chlamydia is often asymptomatic, but when symptoms are present, they can include dysuria, urethral discharge, and frequent urination.
- Neisseria gonorrhoeae infection: Gonorrhea is another common cause of urethritis, also primarily affecting sexually active individuals. Symptoms can be similar to those of chlamydia and include purulent urethral discharge and dysuria.
- Other Likely diagnoses
- Mycoplasma genitalium infection: This bacterium is increasingly recognized as a cause of urethritis, especially in cases where Chlamydia and Gonorrhea have been ruled out. Symptoms are similar to those of chlamydial and gonococcal urethritis.
- Urethritis due to other sexually transmitted infections (STIs): Other STIs, such as herpes simplex virus (HSV) and trichomoniasis, can also cause urethral symptoms, although they are less common causes of urethritis.
- Reactive arthritis: This form of arthritis can occur after certain bacterial infections, including Chlamydia, and may present with urethritis, arthritis, and conjunctivitis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis due to disseminated gonococcal infection: Although rare, gonococcal infection can disseminate and cause life-threatening sepsis. Early recognition and treatment are crucial.
- HIV infection: Individuals with urethritis due to STIs are at increased risk for HIV infection. Testing for HIV should be considered in the diagnostic workup.
- Rare diagnoses
- Urethral cancer: Although extremely rare, cancer of the urethra can present with symptoms similar to those of infectious urethritis, such as dysuria and urethral discharge.
- Foreign body in the urethra: Insertion of foreign objects into the urethra can cause urethritis and should be considered in the differential diagnosis, especially if the patient's history suggests this possibility.