skip to main content

NGNCU and M. genitalium — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateSTIsNGNCU and M. genitaliumSCE Infectious Diseases

A 35-year-old man presents with urethritis. Gram stain of urethral discharge shows >5 PMNs per high-power field but NO organisms visible. NAAT for Chlamydia and Gonorrhoea are both negative. What is the term for this condition and what organism should be tested?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Non-gonococcal non-chlamydial urethritis (NGNCU); test for Mycoplasma genitalium using NAAT with macrolide resistance testing

Urethritis with PMNs but negative Chlamydia and Gonorrhoea NAATs is NGNCU. The most important pathogen to test for is Mycoplasma genitalium (causative in 15–25% of NGNCU). BASHH recommends M. genitalium NAAT with resistance-guided therapy (macrolide resistance testing before treatment). Other causes include Ureaplasma urealyticum, Trichomonas vaginalis, adenovirus, and HSV. Treatment without M. genitalium result: Doxycycline 100 mg BD for 7 days (covers Ureaplasma and has partial M. genitalium activity). If M. genitalium is detected, treatment is guided by resistance testing.

Reference: BASHH 2018 – M. genitalium; BASHH 2019 – Urethritis