16-year-old Sexually in Medicine / Internal Medicine — Case | Infectious Diseases | SMLE Q#348

SMLE Question #348

Medicine / Internal Medicine Infectious Diseases
Last updated: February 2026
A 16-year-old sexually active girl has 2 days of dysuria and urinary frequency. Examination shows suprapubic tenderness without costovertebral angle tenderness. Pelvic examination shows no vaginal discharge and no cervical motion tenderness. Urinalysis shows positive nitrites, positive leukocyte esterase, pyuria, and many bacteria. Urine pregnancy test is negative. Which of the following best describes the pathogenesis of this patient’s infection?

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