[18F] Experiencing recurrent genital ulcers and thick vaginal discharge

Patient Description

An 18-year-old female presents with recurrent painful genital ulcers and thick, yellowish or white vaginal discharge without a significant odor, which has been persistent since October. The discharge is substantial enough to soak through underwear. The patient also experiences aching headaches behind the eyes, rated 6/10 in intensity, which occur on and off and are exacerbated by work. Accompanying symptoms include pain during urination and nausea. There is a history of unprotected sexual activity and new sexual partners prior to the onset of symptoms. No family history of similar symptoms is reported, and no recreational drug use is mentioned. The patient denies pregnancy and has not experienced these symptoms prior to the current episode.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible unifying diagnoses include:

  • Genital Herpes: A sexually transmitted infection caused by the herpes simplex virus. It is characterized by recurrent outbreaks of painful genital ulcers and may be associated with systemic symptoms such as fever and malaise.

    • Treatment typically involves antiviral medication to manage outbreaks and reduce the risk of transmission to partners.

  • Bacterial Vaginosis: An imbalance in the normal bacteria found in your vagina. It can cause increased discharge that is usually white or gray, thin, and with a fishy odor. It may also cause burning during urination or itching around the outside of the vagina.

    • Treatment typically involves antibiotics.

  • Gonorrhea or Chlamydia: Sexually transmitted infections that can cause increased vaginal discharge, burning during urination, and lower abdominal pain.

    • Treatment typically involves antibiotics.

Please note that these are only possible diagnoses. You should consult a healthcare professional for a formal diagnosis.

What you can do

  1. Schedule an appointment with a healthcare provider as soon as possible. They can perform tests to determine the cause of your symptoms and prescribe appropriate treatment.
  2. Avoid sexual activity until you have been evaluated by a healthcare provider to prevent potentially spreading an infection to others.
  3. Over-the-counter pain relievers may help with discomfort and fever.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen or do not improve with treatment.
  • You develop severe abdominal pain.
  • You have a high fever or chills.
  • You experience severe nausea or vomiting.

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9 mo ago

People Also Ask

What are the common symptoms of genital herpes?

Common symptoms of genital herpes include painful blisters or ulcers in the genital area, itching, and sometimes flu-like symptoms such as fever and swollen lymph nodes. The ulcers can recur periodically.

How is bacterial vaginosis different from other vaginal infections?

Bacterial vaginosis is characterized by a thin, white or gray vaginal discharge with a fishy odor, especially after intercourse. It differs from other infections like yeast infections, which typically cause thick, white discharge and intense itching.

What are the risks of untreated gonorrhea or chlamydia?

Untreated gonorrhea or chlamydia can lead to serious health problems, including pelvic inflammatory disease (PID), which can cause chronic pelvic pain and infertility. It can also increase the risk of ectopic pregnancy and can be transmitted to sexual partners.

How can I prevent sexually transmitted infections in the future?

To prevent sexually transmitted infections, use condoms consistently and correctly during sexual activity, limit the number of sexual partners, and get regular STI screenings. It's also important to communicate openly with partners about STI testing and prevention.

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