• Dysuria (burning pain with urination)
• Increased urinary frequency or urgency
• Itching, tenderness, or swelling in penis or groin area
• Fever (rare)
• Discharge from penis (usually moderate, yellow or clear, possibly purulent)
• Pain with intercourse or ejaculation
• Blood in the urine or semen

In women:

• Dysuria
• Increased urinary frequency or urgency
• Fever and chills
• Nausea and vomiting
• Abdominal pain
• Vaginal discharge
• PID (pelvic inflammatory disease)
• Other infections of reproductive organs (cervicitis, salpingitis)
• Fertility problems
• Pelvic pain
• Ectopic pregnancy
• Complications of pregnancy (miscarriage, preterm delivery, premature rupture of membranes, fetal infection, postpartum infection)

A thorough physical examination of genitourinary tract needs to be performed.

For men, this includes abdomen, flank, suprapubic (bladder) area, penile, scrotal and digital rectal exams. These exams may reveal tender and enlarged inguinal lymph nodes (groin area), discharge from the penis, or a tender and swollen penis.

Tests and findings:

• Triple-void urine specimens for urinalysis and culture
  • #1 initial stream
  • #2 mid-stream
  • #3 post (after) prostatic massage by examiner
• Increased WBCs (inflammatory cells) and bacterial growth on culture in urine #1.
• Blood may be noted in urine #1.
• Cultures are obtained for gonorrhea and chlamydia.

For women, evaluation includes thorough abdominal and pelvic exams, evaluation for lower abdominal tenderness, uterine and adnexal tenderness, and purulent (pus)discharge from the urethra or cervix. Microscopic examination of the discharge may also aid in the diagnosis.

Laboratory tests include:

• Pregnancy test
• Urine analysis and culture
• CBC (complete blood count), C-reactive protein
• STD-specific cultures and blood tests
• Pelvic ultrasound