A 27-year-old woman presents with painful urination and vaginal itching. What is the most likely diagnosis based on her examination findings?

The presentation of painful urination and vaginal itching in a 27-year-old woman is most indicative of Trichomoniasis. This sexually transmitted infection, caused by the protozoan Trichomonas vaginalis, commonly leads to symptoms that include vaginal itching, irritation, and discomfort during urination. Patients may also experience a frothy, yellow-green vaginal discharge, which can further support the diagnosis.

The selected answer aligns with the clinical symptoms presented, as both painful urination and itching are characteristic of this infection. Quick identification and treatment are essential, as Trichomoniasis can have implications for reproductive health and can increase the risk of acquiring other sexually transmitted infections.

In contrast, while candidiasis can cause itching and discomfort, it typically presents with a thick, white discharge and does not usually result in painful urination to the same degree. Bacterial vaginosis, on the other hand, may present with a fishy odor and is not generally associated with intense itching or pain during urination. Primary syphilis is characterized by a painless ulcer and does not typically include these specific urinary symptoms. Thus, the symptoms and presentation strongly support Trichomoniasis as the most likely diagnosis in this scenario.