NURS 6501: Final Exam: Please contact Assignment Samurai for help with NURS 6501: Final Exam or any other assignment. Email: assignmentsamurai@gmail.com   A sexually active young adult presents with a clear urethral discharge and dysuria. A Gram-stain of the discharge reveals numerous white blood cells but no organisms. Which organism is most likely responsible for these symptoms? Group of answer choices

• Mycoplasma genitalium
• Ureaplasma urealyticum
• Neisseria gonorrhoeae
• Chlamydia trachomatis

The correct answer is: Chlamydia trachomatis   Explanation: The patient’s symptoms (clear urethral discharge, dysuria) and Gram stain findings (WBCs but no organisms) are classic for non-gonococcal urethritis (NGU), most commonly caused by:

• Chlamydia trachomatis (obligate intracellular bacterium, not visible on Gram stain).
• Mycoplasma genitalium is another cause but is less common than Chlamydia.

Why Not the Others?

• Neisseria gonorrhoeae:
  • Causes purulent discharge with Gram-negative intracellular diplococci on Gram stain.
• Ureaplasma urealyticum:
  • A rare cause of NGU but not as common as Chlamydia.
• Mycoplasma genitalium:
  • Increasingly recognized but still less prevalent than Chlamydia in NGU.

Key Diagnostic Approach:

• NAAT (PCR) testing is the gold standard to confirm Chlamydia or Mycoplasma.
• Empirical treatment for NGU:
  • Azithromycin 1g single dose (covers Chlamydia) or
  • Doxycycline 100mg BID x 7 days (also covers Mycoplasma).

Thus, Chlamydia trachomatis is the most likely cause.