What further laboratory based diagnostic tests would you perform in order to confirm the identity of this microorganism? Discuss the methods available and their potential limitations

Case study

The patient is a 30-year old male from Oklahoma who presented at the GP office with pain when urinating, a sore throat and a purulent green urethral discharge. They are a non-smoker, regularly exercise and have a good diet and have no history of illicit drug use. They recently became sexually involved with a new partner. There are no visible lesions present on their genitalia. Their last HIV test 2 months ago was negative. Initial investigations show the presence of intracellular gram-negative diplococci within the urethral discharge.

Physical exam

• Blood pressure 97/80
• Pulse 67 beats per minute
• Respiration rate 15 breaths per minute
• Temperature 39.2° C
• Chest, heart and abdominal exams are normal
• Normal rectal exam, no sores or rashes
• The genital exam reveals a reddened urethral meatus with a purulent discharge, without lesions.

Q1. What further laboratory based diagnostic tests would you perform in order to confirm the identity of this microorganism? Discuss the methods available and their potential limitations (30 %).

Q2. Outline the pathogenesis of the identified microorganism making reference to the different virulence factors and how they help the establishment of infection. (40 %)

Q3. Explain what treatment options should be considered and describe any potential limitations of these treatments. (30 %)