[23F] With foul-smelling urine, abnormal vaginal discharge, and new onset cough

Patient Description

A 23-year-old female presents with foul-smelling urine and abnormal white discharge inside the lips of her private area, which has been ongoing for about 2-3 days. The discharge is significant and sticks to the inside lips of the vaginal area, accompanied by vaginal itching. The patient reports increased frequency of urination but denies any burning sensation during urination or pain in the lower abdomen or pelvic area. She has a history of bacterial vaginosis (BV) and a urinary tract infection (UTI) treated with antibiotics a few weeks ago. Additionally, she has developed a moderate-intensity cough and sore throat that started about 2-3 hours ago, feeling like something is scratching at her throat. There is no associated fever or chills. The patient was recently exposed to mold at a hotel. She has no pre-existing conditions or chronic illnesses and is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Foul-Smelling Urine and Vaginal Discharge

  1. Urinary Tract Infection (UTI): Even though you recently completed antibiotics for a UTI, it's possible that the infection has recurred or was not fully eradicated. UTIs can cause foul-smelling urine and increased frequency of urination.
  2. Bacterial Vaginosis (BV): BV can cause a fishy odor and abnormal discharge. Since you were recently treated for BV, it’s possible that the infection has recurred.
  3. Yeast Infection: The itching and discharge you described could also be due to a yeast infection, especially if you have taken antibiotics recently, as they can disrupt the natural balance of bacteria and yeast in the vagina.

Scratchy Throat and Cough

  1. Allergic Reaction: Exposure to mold can trigger an allergic reaction, leading to a scratchy throat and cough.
  2. Upper Respiratory Infection: Although your symptoms started recently, they could be the early signs of a viral or bacterial upper respiratory infection.

What you can do

Foul-Smelling Urine and Vaginal Discharge

  • See a Doctor: It's important to consult a healthcare provider to determine the exact cause of your symptoms. They may perform a urine test and a vaginal swab to diagnose the issue.
  • Stay Hydrated: Drink plenty of water to help flush out any potential bacteria from your urinary tract.
  • Maintain Good Hygiene: Keep the vaginal area clean and dry. Avoid using scented products that can irritate the area.
  • Over-the-Counter Treatments: For yeast infections, over-the-counter antifungal treatments are available. However, it's best to get a proper diagnosis before starting any treatment.

Scratchy Throat and Cough

  • Avoid Irritants: Try to stay away from mold and other potential allergens.
  • Stay Hydrated: Drink warm fluids like tea with honey to soothe your throat.
  • Over-the-Counter Remedies: Throat lozenges and cough syrups can provide temporary relief.
  • Monitor Symptoms: If your symptoms worsen or you develop a fever, consult a healthcare provider.

What you should look out for

Given the symptoms you are experiencing, you should seek medical care if you notice any of the following:

  • Fever or Chills: These could indicate a more serious infection.
  • Severe Pain: In your lower abdomen or pelvic area.
  • Blood in Urine: This could be a sign of a more serious urinary tract issue.
  • Difficulty Breathing: Especially if your cough worsens.

Remember, while I can provide some guidance, it's crucial to consult a healthcare professional for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track your progress, get insights, and share your medical notes with your provider.

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6 mo ago

People Also Ask


What are the common symptoms of a urinary tract infection (UTI)?

Common symptoms of a UTI include a strong, persistent urge to urinate, a burning sensation when urinating, passing frequent, small amounts of urine, cloudy or strong-smelling urine, and pelvic pain in women.


How can bacterial vaginosis (BV) be distinguished from a yeast infection?

Bacterial vaginosis typically causes a thin, gray, or white discharge with a fishy odor, while a yeast infection usually results in a thick, white, cottage cheese-like discharge with significant itching and irritation. A healthcare provider can perform tests to accurately diagnose the condition.


What are the potential health effects of mold exposure?

Exposure to mold can cause allergic reactions such as sneezing, runny nose, red eyes, and skin rash. It can also lead to respiratory issues like a cough, wheezing, and throat irritation, especially in individuals with mold allergies or asthma.


What are some effective home remedies for a scratchy throat?

Effective home remedies for a scratchy throat include staying hydrated, drinking warm fluids like tea with honey, using throat lozenges, gargling with salt water, and using a humidifier to keep the air moist.


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