Urethritis is primarily diagnosed based on symptoms, signs of urethral inflammation and microscopic findings. Symptoms may comprise of dysuria, urethral pruritus, burning, Signs of urethral inflammation include urethral discharge, which can be mucoid, mucopurulent, or purulent. Microscopic findings in gonorrheal urethritis include, identification of gram-negative intracellular diplococci (GNID) or purple intracellular diplococci on methylene blue, or gentian violet stain. Presence of Invaded epithelial cells, vacuoles that contain multiple organisms and >2 WBC per oil immersion field. Nongonococcal urethritis (NGU) is microscopically characterized by signs of inflammation with absence of gram-negative intracellular diplococci.

Urethritis is primarily diagnosed based on symptoms, signs of urethral inflammation and microscopic findings.^[1][2][3]

• Symptoms include dysuria, urethral pruritus, burning
• Signs of urethral inflammation include urethral discharge, which can be mucoid, mucopurulent, or purulent.
• Microscopic findings on gram stain include:
  • Gonorrheal urethritis include, identification of gram-negative intracellular diplococci (GNID) or purple intracellular diplococci on methylene blue, or gentian violet stain. Presence of Invaded epithelial cells, vacuoles that contain multiple organisms and >2 WBC per oil immersion field.
  • Nongonococcal urethritis (NGU) is microscopically characterized by signs of inflammation with absence of gram-negative intracellular diplococci.
• If symptoms are present but no evidence of urethral inflammation is present, Nucleic Acid Amplification Tests (NAATs) for C. trachomatis and N. gonorrhoeae might identify infections.