Classically presents as acute urethral discharge following unprotected sex.
The 2 most important etiologic agents are Neisseria gonorrhoeae and Chlamydia trachomatis.
Increased risk is associated with new sex partner, multiple sex partners, or age under 25 years. Disease may be transmitted to infants from infected mothers, resulting in conjunctivitis, iritis, otitis media, or pneumonia.
Higher morbidity in untreated women (10% to 40%) than in men (1% to 2%).
Untreated gonococcal urethritis may disseminate, causing arthritis, meningitis, and endocarditis. Untreated nongonococcal urethritis may present with complications such as reactive arthritis or infertility.
Gram stain of urethral exudate showing gram-negative diplococci and polymorphonuclear leukocytes
Adapted from Public Health Image Library, CDC; Jacobs N, 1974