[24F] Experiencing lethargy, cough, low fever, and muscle pain

Patient Description

A 24-year-old female reports several days of lethargy, a moderate chunky cough with chest discomfort, a low fever, and sharp muscle pain in the lower back, rated 4 out of 10 in intensity, which worsens with bending and lifting. The muscle pain is constant and felt in both the upper and lower back, described as a strain, with a severity rated at 7 out of 10. The patient also experiences a cramping sensation during urination and has a family history of urinary tract infections, with personal history of past UTIs. The patient's medical history includes depression, diagnosed at age 17, and Irritable Bowel Syndrome (IBS), diagnosed at age 8. Current medications include 100 mg of sertraline started in 2020, daily 1500 mg of magnesium oxide, as-needed 10 mg of propranolol, and as-needed 800 mg ibuprofen, along with daily vitamin D and B complex supplements. The patient has an allergy to Amoxicillin, which has previously caused anaphylactic shock.

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Arora's Assessment

What might be happening

Based on the symptoms you've provided, here are some possible conditions:

  • Urinary Tract Infection (UTI): UTIs can cause lower back pain, fever, and painful urination. Given your history of UTIs, this could be a possibility.

    • Treatment usually involves antibiotics prescribed by a healthcare provider.
  • Kidney Infection: This can occur when a UTI spreads to one or both kidneys. Symptoms can include back or side pain, fever, and frequent urination.

    • Treatment involves antibiotics and often requires prompt medical attention to prevent kidney damage.
  • Musculoskeletal Pain: This can be due to strain from coughing or lifting heavy objects. This would not explain your fever or changes in urination, however.

    • Treatment usually involves rest, over-the-counter pain relievers, and physical therapy.
  • Influenza (Flu): The flu can cause muscle pain, fever, and lethargy. It does not typically cause back pain or painful urination, though.

    • Treatment usually involves rest, hydration, and over-the-counter medications to manage symptoms. Antiviral medications may be prescribed in some cases.

Please note that these are possibilities based on the symptoms you've provided, and not a definitive diagnosis.

What you can do

  1. Seek immediate medical attention. Given your symptoms, it's important to get evaluated by a healthcare provider as soon as possible.
  2. Drink plenty of fluids to stay hydrated and help flush out any potential infection.
  3. Rest as much as possible to help your body recover.
  4. Continue taking your prescribed medications as directed by your healthcare provider.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe pain or discomfort
  • High fever (over 102°F)
  • Blood in your urine
  • Nausea or vomiting
  • Symptoms that worsen or do not improve with treatment

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 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 during urination, cloudy or strong-smelling urine, and pelvic pain in women. Fever and back pain can also occur if the infection spreads.


How can I differentiate between a kidney infection and a UTI?

A kidney infection, which is more serious, often includes symptoms of a UTI along with back or side pain, high fever, chills, nausea, and vomiting. It requires prompt medical attention to prevent complications.


What are some effective ways to manage musculoskeletal pain caused by strain?

Managing musculoskeletal pain from strain typically involves rest, applying ice or heat to the affected area, over-the-counter pain relievers like ibuprofen, and gentle stretching or physical therapy exercises as recommended by a healthcare provider.


Can the flu cause back pain and what are its typical symptoms?

The flu can cause muscle aches and general body pain, but it does not typically cause localized back pain. Typical flu symptoms include fever, chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue.

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