Editing Sexually Transmitted Infections (section)

=== Diagnosis and Evaluation ===
* '''History and Physical Exam'''
** '''History'''
*** '''Symptoms of urethritis include urethral discharge, pruritus, and dysuria'''
*** '''Gonorrhea'''
**** Campbell’s: Men will usually have symptoms that cause them to seek treatment soon enough to prevent transmission to others. This could include urethritis, epididymitis, proctitis or prostatitis.
***** CUAJ Penile Lesions Review 2019: In men, it is most often asymptomatic, but symptoms can include dysuria or mucopurulent discharge. [but multiple sources including Public Health Ontario and UptoDate say gonorrhea is symptomatic in most men)
**** '''Women are frequently asymptomatic.'''
*** '''Chlamydia'''
**** '''Symptoms in males include dysuria, urethral discharge, and epididymitis'''
***** [UptoDate] up to 42% of men with NGU are asymptomatic
**** '''Up to 75% of women with chlamydial infection can be asymptomatic.'''
*** '''Mycoplasma genitalium'''
**** Most infected patients are symptomatic, but ≈25% may have asymptomatic urethral infection
** '''Labs'''
*** '''Nucleic acid amplification tests (NAATs) performed on urine'''
**** '''Can be used to look for gonorrhoeae and chlamydia'''
***** '''All patients should be tested for both gonorrhea and chlamydia, given the high association of co-infection.'''
**** Culture and hybridization tests that require urethral swab specimens are available. However, NAATs are preferred because of their higher sensitivity, and urethral swabs are no longer recommended for evaluation of urethritis
**** Culture for Mycoplasma genitalium is very difficult, and the diagnosis is made by NAATs or polymerase chain reaction (PCR)
**** '''NAAT has replaced wet mounts and culture for diagnosis of trichomonas vaginalis'''