Patient presents with discharge per urethrum and microscopy shows presence of intracytoplasmic gram negative cocci; what is the most probable diagnosis ?
**Core Concept**
The patient's symptoms and microscopy findings suggest a urinary tract infection (UTI) caused by a gram-negative bacterium. The presence of intracytoplasmic gram-negative cocci is indicative of a specific type of bacteria that can cause UTIs.
**Why the Correct Answer is Right**
The patient's symptoms of discharge per urethrum, combined with the microscopy findings of intracytoplasmic gram-negative cocci, are characteristic of a Neisseria gonorrhoeae infection. Neisseria gonorrhoeae is a gram-negative diplococcus that can cause urethritis, a type of UTI. The bacteria invade the mucosal cells of the urethra, leading to inflammation and discharge. The intracytoplasmic gram-negative cocci observed under microscopy are a key diagnostic feature of this infection.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not relevant to the patient's symptoms and microscopy findings.
* **Option B:** This option may be a consideration for other types of UTIs, but the presence of intracytoplasmic gram-negative cocci points towards a specific diagnosis.
* **Option C:** This option is incorrect as it refers to a different type of bacteria that can cause UTIs, but the microscopy findings do not match.
**Clinical Pearl / High-Yield Fact**
In patients presenting with discharge per urethrum and microscopy showing intracytoplasmic gram-negative cocci, consider Neisseria gonorrhoeae infection in the differential diagnosis. This is a classic exam trap, as other types of UTIs may present with similar symptoms, but the microscopy findings can help narrow down the diagnosis.
**Correct Answer:** D.