[23F] With lower left abdominal pain, upper right back pain, and vaginal discharge
Patient Description
A 23-year-old female presents with a week-long history of constant burning pain in the lower left side of her abdomen, upper right back beneath the shoulder blade, and down the left leg. She also reports a very constant, heavy flow of watery, light yellow vaginal discharge with associated irritation, swelling, discoloration, and occasionally a light chemical smell. The patient has experienced chills but no fever. She reports painful urination with a persistent urge to urinate even after finishing. The discharge and abdominal pain both began suddenly about a week ago. The patient has had a new sexual partner recently and did not use protection. She has not experienced any abnormal vaginal bleeding or nausea and vomiting but reports major fatigue and weakness. There is no family history of heart disease, stroke, autoimmune diseases, diabetes, cancer, or psychiatric illnesses. Her medical history includes vitamin deficiency, anxiety, and depressive disorder. No known drug allergies.
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Arora's Assessment
What might be happening
Based on the symptoms you've described, here are some possible explanations:
Vaginal Discharge and Painful Urination
- Sexually Transmitted Infections (STIs): Given your recent unprotected sexual activity and the sudden onset of symptoms, STIs such as chlamydia, gonorrhea, or trichomoniasis could be causing the discharge, irritation, and painful urination. These infections often present with abnormal discharge and discomfort.
- Bacterial Vaginosis (BV): This is a common vaginal infection that can cause a watery, yellow discharge with a chemical smell. It often results from an imbalance in the vaginal flora.
- Yeast Infection: While typically associated with a thick, white discharge, yeast infections can sometimes present with watery discharge and irritation.
Abdominal and Body Pain
- Pelvic Inflammatory Disease (PID): This is a serious complication of untreated STIs and can cause lower abdominal pain, fever, and unusual discharge.
- Musculoskeletal Issues: The pain in your lower left side, upper right back, and down your left leg could be related to musculoskeletal problems such as a pinched nerve or muscle strain.
- Urinary Tract Infection (UTI): UTIs can cause lower abdominal pain, painful urination, and a sensation of incomplete bladder emptying.
Fatigue and Weakness
- Infection: Ongoing infections, including STIs or UTIs, can lead to systemic symptoms like fatigue and weakness.
- Vitamin Deficiency: Given your history of vitamin deficiencies, it's possible that low levels of certain vitamins could be contributing to your fatigue.
What you can do
Vaginal Discharge and Painful Urination
- Seek Medical Attention: Schedule an appointment with your healthcare provider as soon as possible to get tested for STIs and other infections. Early diagnosis and treatment are crucial.
- Maintain Hygiene: Keep the genital area clean and dry. Avoid using scented products that can cause irritation.
- Avoid Intercourse: Until you have been evaluated by a healthcare provider, it’s best to avoid sexual activity to prevent potential spread of infection.
Abdominal and Body Pain
- Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain. Follow the dosage instructions carefully.
- Rest and Hydration: Ensure you get plenty of rest and stay hydrated. This can help your body fight off any potential infections.
- Warm Compress: Applying a warm compress to the painful areas may provide some relief.
Fatigue and Weakness
- Balanced Diet: Ensure you are eating a balanced diet rich in vitamins and minerals. Consider taking your prescribed vitamin supplements regularly.
- Monitor Symptoms: Use MDandMe to journal your symptoms, track progress, and get insights. This can help you and your healthcare provider understand your condition better.
What you should look out for
Given the severity of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:
- Fever or worsening chills
- Severe abdominal pain
- Increased pain or swelling
- New or worsening symptoms
Remember, while I can provide guidance, it's essential to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.
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5 mo ago