Evaluating dysuria in adolescent females

Adolescent females presenting with acute dysuria in primary care settings are often assumed to have urinary tract infections and are evaluated accordingly. Dysuria, with or without a change in vaginal discharge, is also often associated with sexually transmitted infections, usually urethritis, even when the patient does not report a history of sexual activity. An adolescent female with dysuria, an abnormal urinalysis, and a negative urine culture has a high probability of having a sexually transmitted infection. Although providers who treat adolescents should not assume all of their patients are sexually active, it is essential that they ask questions about their patients' past and present sexual activity and consider the possibility of sexually transmitted diseases in young women presenting with this symptom.